



m 



A MEDICAL MANUAL 

AND 

MEDICINE CHEST COMPANION, 

FOR POPULAR USE 

IN FAMILIES AND ON SHIP BOARD, 

FOR THE TREATMENT 

OF THE 

(Drtanj Wwmm nf iljf Intuitu itprtwH. 

BY THOMAS BITTER, M.D., 

MEMBER OF THE NEW YORK COUNTY MEDICAL SOCIETY. 

FOURTH EDITION, REVISED AND ENLARGED, 



NEW YORK: 
W. BENEDICT, 16 SPRUCE STREET, 

1849. 



N v ADVERTISEMENT. 

The subscriber devotes his energies chiefly to the 
business of putting up Medicine Chests for families 5 
ships and plantations. His prices for new chests, and 
for replenishing, have given very general satisfaction. 
Having put up some thousands^ he ventures to say that 
for neatness of style, the excellent quality of the medi* 
cines, and for the care taken for the preservation of the 
perishable articles, he is exceeded by no one in the 
country. In the replenishing of Medicine Chests, he 
is strictly careful to put up only such quantities as 
may be needed, never crowding the chest in order to 
enhance the amount of the bill. The bill itself is made 
out by items. A single ounce or dose is furnished at 
the same price as a large quantity, and sent to any part 
of the port free of expense. The articles in the " Se* 
condary List" supplied, when ordered, at reduced rates. 

All kinds of drugs, medicines, perfumery, surgi- 
cal instruments, wholesale and retail, furnished for 
the West India, or other markets at the lowest prices, 

patent medicines of all kinds. 

swaim's panacea. 

concentrated syrup of sarsaparilla. 

lee's PILLS* 

HARLEM OIL. 

BALSAM OF LIFE. 

SODA, AND SEIDLITZ POWDERS. 

COUGH DROPS, &C, &C. 

THOMAS HITTER, M.D., 

104 Cherry-street, New York, 

Four doors above Oliver* 



Entered according to Act of Congress in the year 1849, by 
THOMAS RITTER, in the Clerk's Office of the District Court of 
the United States for the Southern District of New York. 



PREFACE TO THE FIRST EDITION. 



The author df this little work has been extensively 
engaged for several years past in putting up Medicine 
Chests for sea service. Of late he has devoted his 
whole attention to this branch of business. Many dif- 
ferent books of directions have come tinder his notice, 
the largest share of which were very defective. Ex- 
tensive intercourse with ship-masters and seamen has 
made him acquainted with their wants, and he flatters 
himself that he now presents to them a book of direc- 
tions better adapted to their circumstances than any 
other to be found among the druggists of this city. 

The writer has aimed at great simplicity in descrip- 
tion and direction. Making no attempts to recommend 
himself by a show of learning, he has endeavored to 
adapt every sentence and every word of the book to 
the simplest mind, content if he may be useful to a 
class of men whose whole life is one of exposure and 
peril. Parts of the book are compiled from various 
sources ; a large part, however, is the result of nine- 
teen years' experience. It is not to be expected that 
every desirable article should be found in a ship, or 
family medicine chest ; yet there are few diseases to 
which sea-faring men, or even families on shore, are 
exposed, for which an intelligent physician could not 
prescribe, out of the chests put up according to this 
book. 

It has been the design of the author^ in all cases 



where two or more remedies may be used for the same 
disease, to mention them all, as it may often happen 
that the first mentioned article is not on hand, while 
another is, which will answer the same purpose. 

It is a common fault of medicine-chest books that the 
directions are only for the first stage of the diseases. 
The writer has endeavored to detail the treatment of 
diseases to their termination. It is not to be expected 
that in the limits of such a work as this, every thing 
can be directed that is desirable to know, yet it is hoped 
that, through the Divine blessing, it may help to relieve 
human suffering, and preserve life when other means 
are not within reach. 



PREFACE TO THE THIRD EDITION, 



With much diffidence the author issued the first 
edition of this Manual. Of the many books of the kind 
that had come under his notice, all seemed to lack sev- 
eral things that are desirable in an accompaniment to a 
Medicine Chest. There are very few persons, not prac- 
titioners, who do not need very particular directions for 
the preparation and the administering of the medicines. 
The two best books the author has seen lack a materia 
medica, or a particular account of the uses and modes 
of administering each article in the Chesty with the 
needful cautions respecting over-doses and mistakes 
likely to occur. These desirable things the author of 
this book has endeavored to supply. He has been 
gratified, beyond all expectation, with the frequently 
expressed commendations of ship-masters and others^ 
several of whom have remarked that the directions 
were so plain that a person wholly ignorant of Medi- 
cine would be unlikely to make a mistake. 

This edition has been thoroughly revised and con* 
siderably enlarged. The author has been requested by 
several gentlemen in charge of passenger ships, to add 
to the chapter on Midwifery some directions for female 
complaints. This he has done, with reference both to 
families and shipping. He has also enlarged the de° 
partment of Children's Diseases. 

Some of the remedies directed in this edition^ for fe- 
male and other complaints, are not in the regular Medi~ 
cine Chest list, but may be procured at any respectable 
drug store. It having been suggested by friends, that 
this edition be prepared more with reference to popular 
use, the author has had this end in view, and added a 
secondary list of medicines not ordinarily to be expected 
in a Medicine Chest, unless particularly ordered. 

New York, Jan. 1, 1847. 
1* 



CONTENTS OF THE CHEST- 

No. 
1. Tartar Emetic - 



2. Calomel and Jalap 

3. Calomel 

4. Powdered Rhubarb 

5. Calcined Magnesia 

6. Purging Pills 

7. Mercurial Pills - - 

8. Epsom Salts 



9. Sulphur 

10. Cream of Tartar 

11. Peruvian Bark - 



12. Castor Oil 

13. Paregoric 

14. Elixir Vitriol - - 

15. Fryar's Balsam 



16. Laudanum 

17. Hartshorn 

18. Essence Peppermint 

19. Mercurial Solution < 

20. Spirits Nitre 

21. Sulphuric Ether - - 



22. Syrup Squills 

23. Opodeldoc, or Cam- 
phorated Soap Lini- 
ment. 

24. Balsam Copaiva - - 

25. Tine. Bark or Bitters 

26. Spirits Camphor - 



Doses, &c. 

Six grains, or the contents of one 
of the papers, in divided doses. 

15 grains of each to each dose. 

15 do. do, do. 

30 to 40 grains, or one teaspoon- 
ful in molasses or water, 
drachm, or two heaped tea- 
spoonsful. 

3 to 4. 

3 to 4 when used as a purge, 
oz. to 2 oz. or 2 to 4 large- 
spoonsful in cold water, 
to 4 teaspoonsful in water or 
molasses. 

2 large spoonsful heaped in half 
a tumbler of cold water, is an 
excellent purge. 

A teaspoonful in water or wine 
three times a day. 

2 to 4 large spoonsful. 

1 to 2 teaspoonsful for an adult. 

10 to 30 drops in sweetened wa- 
ter. 

20 to 30 do. on sugar, when 
taken internally. 

20 to 60 drops for an adult, [use. 

20 drops in water for internal 

20 to 40 drops. 

is Corros. Sub. [ J^^S 



10 grains, < ~ 
Alcohol, loz. » ' 



of 



tumbler 
[ water. 
30 drops to a teaspoonful in cold 

water. 
One teaspoonful to a tablespoon- 
ful in sweetened water. Drink 
immediately. 
One teaspoonful, frequently re- 
peated. 



30 to 60 drops in water or sugar.. 
A teaspoonful in wine or watery 

three or four times a day. 
20 to 30 drops in water. 



No. 

27. Spirits Lavender - - 

28. Antimonial Wine - - 

29. Cerate. 
80. Basilicon. 

31. Mercurial Ointment. 

32. Spread Adhesive 
Plaster. 

33. Blister Plaster- - - 

34. Strengthening Plas- 
ter. 

35. Surgeon's Lint. 

SQ. Chamomile 

37. Flaxseed 

38. Arrowroot 

39. Red Precipitate. 

40. Blue Vitriol. 

41. White Vitriol 

42. Sugar of Lead 

43. Alum. 

44. Powdered Kino 

45. Fever (James') Pow- 
ders 

46. Dover's Powders - - 

47. Ipecac 

48. Quinine 



49. Boneset (Thor'wort) 

50. Salt Petre or Nitre 

51. Syringe. 

52. Lancet. 

Bougies, Surgeon's Needles, Bandages, &c. 



Doses, &c, 

30 drops to a teaspoonful in wa- 
ter. 

1 to 4 teaspoonsful for an adult ; 
10 drops to 40 for a child. 



May be spread on leather, mus- 
lin, or brown paper. 



A handful to a quart of tea. 
2 tablespoonsful to a pint of tea. 
A tablespoonful makes a pint of 
gruel. 

20 to 30 grains for a speedy 
emetic, in divided doses. 

A teaspoonful to a pint of water 
for a wash. 

15 to 30 grains in molasses. 

6 grains,- or the contents of one 
of the papers in molasses. 

10 to 15 grains, do. do. do. 

30 to 40 grains in boiling water. 

1 grain with 10 drops Elix. Vit- 
riol and water. 

| oz. to a pint of boiling water. 

20 grains, or half a teaspoonful 
in a little cold water. 



SECONDARY LIST FOR PACKET SHIPS 
FAMILIES, 



AND 



Sulphate of Morphine. 
Gum Arabic. 
Essence of Cinnamon. 
Opium and Opium Pills. 
Compound Tinct. Rhubarb. 
Uva Ursi. 
Hydriodate of Potash. 



Super Carbonate of Soda. 
Tincture of Myrrh. 
Muriated Tincture of Iron, 
Oil of Cloves. 
Powdered Cubebs. 
Lunar Caustic. 



blRECTIONS CONCERNING DOSES. 

The doses of the foregoing medicines are for persons 
of good constitution, from 18 years of age and up- 
wards. Under 18 years of age, the dose to be chiefly 
as follows : Children even in infancy, however, will 
take 8 or 10 grains of calomel for an ordinary dose, 
for worms or other complaints. 

One year old, give one twelfth of the dose specified. 

From 1 to 2, one eighth " " 

2 to 3, one sixth " 

3 to 4, one fourth " 

4 to 7, one third " 
7 to 14, one half " 
14 to 18, two thirds " 



SCALES AND WEIGHTS. 

Mie smallest weights in the box are grains ; each czr- 
cular impression stands for one grain. There are six 
other weights in the same box, viz :— - 
2 Drachms, 3ij> or 120 grains. 

1 Drachm, 3j- 

J Drachm, 5ss, or 30 grains. 

2 Scruples, 9ij. 

1 Scruple, 9j or 20 grains. 
| Scruple, Bss. 
The respective denominations of which are plainly 
marked. 



MEASURES. 

An ordinary sized teaspoon contains about 90 drops 
or 5j 5 one drachm. A tablespoon, §ss, or half an 
ounce. An ordinary sized tumbler, gviii, or eight 
ounces. A wine-glass, |ij, or two ounces. 



MATERIA MEDICA, 

DIRECTIONS. 

No. 1. TARTAR EMETIC. 

Dissolve six grains, or the contents of one of the 
papers, in six tablespoonsful of water, and give one 
spoonful every ten minutes, until it operates freely. 
Give lukewarm water, boneset or chamomile tea, dur- 
ing the operation. Cramps are to be allayed by twenty 
drops of laudanum, (No. 16.) Strong green tea, Pe- 
ruvian Bark, (No. 11,) or common salt and water, 
should be given to check excessive vomiting, or a mus- 
tard plaster may be applied to the stomach externally. 

To reduce fever and promote sweat, two grains, or 
one-third of the contents of one of the papers may be 
dissolved in a tumbler of cold water, of which the pa- 
tient may take from one to two tablespoonsful every 
hour, or two hours. This is peculiarly useful after 
bleeding, — in pleurisy, — in coughs and colds. Should 
this move the bowels too freely, it should be omitted. 
Emetics should be used with great care, where there is 
a determination of the blood to the head, especially in 
persons of full habit, and when the patient has a rup- 
ture. Tartar emetic should not be used in what are 
called sinking diseases, as low typhus, or ship fevers, 
scurvy, &c, nor in inflammation of the stomach and 
bowels. Ipecac, (No. 47,) may be substituted, and used 
also at any time when a gentle emetic is required. 
(See Antimonial Wine, No. 28.) 

No. 2. CALOMEL AND JALAP, 

Is one of the most useful purges in bilious diseases, 
and proper to be used as an ordinary cathartic. Each 
paper contains thirty grains of calomel and jalap, being 
in equal parts, and may be taken in molasses or honey. 
These medicines should be kept in bottles, air-tight, as 
they soon lose their virtue from bilge water and damp- 
ness. 



10 

No. 3. CALOMEL. 
Each paper contains fifteen grains, and in this dose is 
useful in bilious attacks, in the commencement of diar- 
rhoea and dysentery, and in the course of these diseases, 
in the dose of one-third or half a grain with the same 
quantity of Ipecac, (No. 47.) every three hours, to change 
the secretions, and also where the tongue is coated with 
a moist yellow fur, and in a foul or acid state of the 
stomach. A very little upon the point of a penknife 
may be a sufficient measure for one-third or half a 
grain. Calomel is one of the best remedies for worms, 
either in children or adults* The latter may take 15 or 
20 grains at night, followed by a dose of Pills, (No. 6,) 
next morning. Children from 5 to 10 grains. 

No. 4. RHUBARB. 

An excellent purgative in diarrhoea or looseness, es* 
pecially when combined with calomel or magnesia. A 
teaspoonful of rhubarb, or about 30 or 40 grains, and 
two to four teaspoonsful of magnesia, with a few drops 
of Essence of Peppermint* (No. 18,) in half a tumbler 
of water, or the same quantity of rhubarb, and 5 or 10 
grains of calomel in molasses, are suitable doses. This 
article is very apt to render the patient costive, yet if 
the root is chewed, and the saliva only swallowed by 
persons of dyspeptic habits, it may prove laxative with- 
out this inconvenience. Dose for children, 5 to 20 
grains, from the age of one month to fourteen years. 

No. 5. CALCINED MAGNESIA, 
Should be kept in closely stopped bottles. It is use- 
ful in the dose of one to two teaspoonsful} in heartburn 
or sour stomach, or as a gentle purge, in milk or water, 
for children or adults. It is frequently combined with 
rhubarb, and given for diarrhoea or a foul stomach. 
Children take from 10 to 30 grains. 

No. 6. PURGING PILLS* 
Are a thorough and speedy purge, suitable for bilious 
complaints, foul stomach, obstinate costiveness, and for 
all cases requiring strong physic. These pills are com* 
posed of Aloes* Gamboge, Colocynth and Rhubarb. 



11 

No. 7. MERCURIAL PILLS. 

Useful as a purge in the case of a foul tongue and 
yellow fur, which sometimes appears in the morning 
with an unpleasant taste in the mouth. Dose 3 to 4. 
Useful also in liver complaint and venereal disease. 
(See Venereal Disease.) 

No. 8. EPSOM SALTS, 

May be taken in the dose of one to two ounces, or 
two to four large spoonsful dissolved in a tumbler of 
cold water. They are a very cooling purge in fevers, 
and in external and internal inflammation. 

Jg®^ When a person has taken by mistake, or other- 
wise, an overdose of sugar of lead, or extract of lead, 
the best antidote to the poison is epsom salts dissolved 
and drank as soon as possible. They decompose the 
poison and carry it out of the system. Salts should 
not be taken to relieve a costive habit as they increase 
it. 

No. 9. SULPHUR, 

If it were not for the odor that sometimes attends its 
operation, would be more used as a laxative than any 
other medicine. It is an excellent remedy in rheuma- 
tism in small doses of half a teaspoonful three or four 
times a day, in molasses or water, and in the dose of 
a large spoonful at night also. In dysentery, with pain 
and bloody stools, give a teaspoonful three times a day 
with strong flaxseed tea. It is a very good laxative in 
piles. It relieves salivation. Made into an ointment, 
with one part sulphur, and lard two parts, it is a sove- 
reign remedy for the itch. Dose for children, one tea- 
spoonful. 

No. 10. CREAM OF TARTAR. 
In the dose of an ounce or two large spoonsful 
heaped, in half a tumbler of cold or hot water sweet- 
ened, is a cooling and agreeable purgative. It is thus 
highly useful in dropsy, skin complaints, and in smaller 
doses, frequently repeated, in complaints of the kidney 
and bladder, such as gravel, strangury, &c. A heaped 
teaspoonful of cream of tartar and twenty to twenty- 



12 

five grains of jalap, in molasses or water, forms an ex- 
cellent cathartic, especially in dropsical cases. 

As a cooling drink in fevers it is of great service. 
The following is a very agreeable beverage : — Take 
cream of tartar, two teaspoonfuls a little heaped, and 
the rind of one lemon ; pour on these a quart of boil- 
ing water, and when cold, add sugar to make it pala- 
table. 

No. 11. PERUVIAN BARK. 
For the various uses of this medicine, see fevers, 
gangrenes, decoction of bark, &c. As this article is of 
varied strength, and easily loses its virtue at sea, 
Quinine, (No. 48,) is preferable for most purposes for 
which bark is prescribed. Dose, a teaspoonful. 

No. 12. CASTOR OIL. 
Well known as a mild and speedy purge, operating 
sooner than most other cathartics. It is much used in 
dysentery. Dose, from one to four large spoonsful, to 
which may be added ten drops of Laudanum, (No. 16,) 
if it occasions griping. Some cases of cramp in the 
stomach are relieved by two or three teaspoonsful of 
castor oil and thirty drops of balsam copaiva combined. 
Dose for children, two to four teaspoonsful. 

No. 13. PAREGORIC ELIXIR. 

For coughs arising from irritation or tickling in the 
chest, where there is no inflammation, one or two tea- 
spoonsful may be taken in water or flaxseed tea, three 
times a day. It is also used for children to quiet rest- 
lessness and promote sleep. Dose for children, 16 
drops to a teaspoonful. 16 drops contain one drop of 
laudanum. (See Cough Drops, p. 30.) 

No. 14. ELIXIR VITRIOL. 
It is an excellent tonic for indigestion or debility of 
the stomach 5 and for general weakness of the system, 
especially when combined with a grain or two of 
white vitriol. It is a remedy generally used for night 
sweats, and is useful to check profuse sweats of any 
kind, to increase the appetite, and for the scurvy of the 



IS 

gums, or for general scurvy, in tlie dose of 15 drops ta 
BO, in a wine glass or more of sweetened water, three 
or four times a day. In bleeding from the lungs, ten 
drops may be taken every hour or two, unless sugar of 
lead has been taken just before. It should not be ad- 
ministered soon after the lead has been taken for the 
same purpose, as they mutually destroy each other's 
medical powers, (See Sugar of Lead, No. 42.) Thirty 
or forty drops to a tumbler of water, with the addition 
of a little sugar, makes a cooling drink in fevers. 
This medicine may be used with the Tinct. Bark, (No. 
25,) and with the decoction of bark, as a strengthening 
remedy after fevers, or other debilitating diseases. The 
doses of Quinine, (No. 48,) may be combined with, anil 
be dissolved in it with the addition of a tablespoonfol 
of water to five drops of the elixir "vitriol. 

No. 15. TURLINGTON'S, OR FRYAR ? S BALSAM, 

Is most generally used as an application to wounds 
and sores. It is a good remedy, taken inwardly, for 
coughs, cramp in the stomach and bowels. It lias beem 
found useful to stop bleeding from the lungs, for diar- 
rhoea of long standing, especially that occasioned by 
ulcerations of the bowels. Dose, 30 drops to two tea- 
spoonsfuL 

No. 16. LAUDANUM^ 

Twenty to forty drops procure sleep and relieve pain g 
and may be repeated in half an hour if the pain con* 
tinues. If the pain is severe without inSammatioxi of 
some vital or important organ, the dose may be in- 
creased to sixty drops, and m extreme pain to a tea* 
spoonful. In diarrhoea, laudanum is ordinarily unsa£@ 3 
until after the operation of a cathartic. In Asiatic 
cholera, laudanum is of the greatest importance. It 
should be given in full doses, combined with ether, 
hartshorn, camphor, and peppermint, as directed in the 
article upon this disease. Twenty-five drops is equal 
to a grain of opium, or ten grains of Dover's powders. 
When used by injection, the system will bear four 
times the quantity taken by the mouth, (See Recipes 
2 



14 

for Anodyne Injection, p. 31.) fl@* Laudanum, when 
long kept, sometimes deposits a part of the opium, and 
(becomes turbid ; when this is the case, it should be 
carefully filtered through unsized paper, before it is 
used internally, as it is unsafe, because its strength is 
uncertain. 

No. 17. HARTSHORN.— (Aqua Ammonice.) 
May be applied to the nostrils, and 20 drops in a 
little water may also be taken into the stomach for 
faintings, fits, &c. Equal parts of hartshorn and olive 
oil form a volatile liniment. In cramps and in severe 
pains of the stomach and bowels, equal parts of Ether, 
(No. 21,) Spirits Camphor, (No. 26,) Laudanum, (No. 
16,) and Spirits of Lavender, (No. 27,) may be given 
in sugar and water, in the dose of one to two teaspoons- 
ful, and repeated in half an hour if necessary. 

No. 18. ESSENCE OF PEPPERMINT. 
A suitable remedy to relieve pain and griping of the 
stomach and bowels from wind. Dose, 20 to 30 drops 
on sugar, or in a little warm water. 

No. 19. MERCURIAL SOLUTION, 
Is corrosive sublimate ten grains, alcohol one ounce r 
and is useful in the dose of from six to ten drops, twice 
a day in water, in some obstinate eruptions of the skin. 
It acts as a caustic upon a raw or ulcerated surface. 
(See Venereal Disease.) 

No. 20. SPIRITS OF NITRE, 
In doses from 20 to 60 drops, in a suitable quantity 
of water, relieves fever, allays thkst r expels wind, and 
strengthens the stomach. For urinary complaints, it 
should be taken in the dose of from one to three tea- 
spoonsful. Equal parts of Spirits Nitre, Ether, and 
Antimonial Wine, in the dose of a teaspoonful every 
two or three hours, is an excellent medicine to produce 
sweating and relieve fever. 

No. 21. SULPHURIC ETHER. 
This medicine ought to be in every medicine ches^ 



15 

and every family. Its great variety of uses, its instant 
operation, renders it of great value in sudden attacks. 
its influence is felt to the ends of the fingers and toes 
almost as soon as swallowed. It relieves cramp, diz- 
ziness, palpitation of the heart, cholera morbus, Asiatic 
cholera, faintings, wind in the stomach and bowels pro- 
ducing cholic. Asthma is relieved on breathing the 
vapor of ether. It may be used for wind cholic by in- 
jection, mixed with the common laxative injection, 
(See Recipes, p. 31.) I have never found any remedy 
so speedily to compose both mind and body in delirium 
tremens, or the horrors, after an emetic. (See Delirium 
Tremens.) It is useful also in dyspepsia, combined 
with Tinct. Bark, (No. 25,) three or four times a day. 
It may be applied externally for head-ache, tooth-ache, 
rheumatism, gout, ruptures. (See Ruptures.) Dose, 
one teaspoonful in sugar and water every half hour 
until relief ensues. 

The water and sugar should be first mixed, and when 
the patient is ready to receive the dose, the ether should 
be added and swallowed immediately, as it evaporates 
very rapidly. Great care should be taken to keep this 
article from a lamp, as it takes fire as readily as gun- 
powder. 

No. 22. SYRUP OF SQUILLS, 
Is used chiefly in hoarseness and coughs, either alone 
or in combination with other expectorants. Dose one 
to two teaspoonsful. (See Coughs and Colds.) 

No. 23. OPODELDOC, or SOAP LINIMENT, 
Is used to rub joints and other parts of the body 
affected with rheumatic or other pains, bruises, swel- 
lings. &c. One ounce or two tablespoonsful of opo- 
deldoc, and two drachms, or two teaspoonsful of Lau- 
danum, (No. 16,) forms an anodyne liniment for dispers- 
ing indurations., swellings attended with pains without 
inflammation. 

No. 24. BALSAM COPAIVA, 
Is a remedy for various diseases, which are seated in 
those membranes which line all the passages or cavities 



1® 

that open outwards,, as piles, gonorrhoea, &r clap, m 
chronic inflammation of the air passages of the lungs, 
in coughs arising from this cause, and in a relaxed 
state oi the palate and hack parts of the throat. It is 
useful also in that disease commonly called catarrh, 
accompanied by a discharge from the hack part of the 
aostrils, like the white of an egg y and sometimes 
offensive. Some cases of costiveness also are much 
relieved by this medicine. It may he also used in 
strains affecting the kidney. Bose, SO drops to a tea- 
spoonful, three times* a day. 

No. 25. TINCT. BARK, or BITTERS. 

Dose, one or two tea spoonsful in water or wine r 
with or without 10 or 12 drops of Elixir Vitriol, (No. 14,) 
thrice a day for scurvy, debility, or loss of apetite. 

No. 26. SPIRITS CAMPHOR. 

One teaspoonful is equal to four grains of gum cam* 
yhor, twenty-five drops to one grain. Spirits camphor 
is used externally for head-ache and other pains, in- 
flammations, numbness, sprains, &c. It is one of the 
best remedies for small worms in the extremity of the 
bowels, hj injection, in the dose of two teaspoonsful 
of the spirits of camphor in half a tumbler of milk, 
oil, or water. Dose by the mouth,* 20 drops to a tea 
spoonful, in water. 

No. 27. SPIRITS OF LAVENDER. / 

Anti-spasmodic and stimulant, in general use against 
nervous diseases, lawness of spirits, weakness, trem- 
bling, fainting, hysterics, seasickness, and to flavor 
ather medicines. Dose, SO to 50 drops. 

No. 28. ANTIMONIAL WINE. 

A tablespoonful contains one grain of tartar emetic. 
Half a teaspoonful, or 40 drops, is equal to one- 
eighth of a grain. Antimonial wine is used as an 
emetic, and also as an expectorant and febrifuge. Where 
it is designed to vomit, a child six months old may take 
S drops,— 



17 

1 to 2 years, may take - 10 to 15 drops, 
3 to 4 " - -- - 20 to 30 « 
5 to 6 " - - - 40 to 50 '" 

7 to 15 " - - from 1 to 1 4 teaspoonsful* 
to be repeated every fifteen minutes till it operates. 

A grown person may take a tablespoonful at once, 
and two teaspoonsful every fifteen minutes afterwards 
till an ounce has been taken, or vomiting produced * 
promoting its operation by drinking freely of warm 
water, or chamomile tea. When it 'operates too se- 
verely, a small quantity of salt and water, or strong 
green + ea, will check it, and turn the effect downwards. 
(See Cough Drops.) 

No. 29. TURNER'S CERATE, 
Is an excellent application to ulcerations arising from 
burns and scalds. It may be applied to any healthy 
sores, trifling injuries of the skin, and as a healing 
dressing to blisters. It may be used for the same pur- 
pose as Simple Cerate. 

No. 30. BASILICON. 
Useful to keep blisters open, applied on cotton or 
linen cloth, for burns and scalds, and to stimulate and 
procure a healthy discharge from ulcers that are not 
clean, and from wounds disposed to heal but slowly. 
The dressings should be renewed twice a day. 

No . "3 1 . MERCURIAL OINTMENT, 
Is used to destroy vermin upon the human body. 
Rub a little on the parts affected. (See Venereal Dis- 
ease.) Steel and iron covered with a little of this oint- 
ment will be preserved a long time free from rust 

No. 32. SPREAD ADHESIVE PLASTER. 

This is the best and most convenient application to 
^uts and other fresh wounds. The dirt, blood, &c, 
should be washed out, the plaster cut into strips one- 
eighth to one-quarter of an inch wide, and in cool 
weather warmed and applied. Let the edges of the 
wound be as closely drawn as possible, until the whole 
oi the wound is covered. A piece of Lint, (No. 35-} 
2* 



m 

spread with Basilicon, may be laid oyer the strips, anci 
a bandage bound moderately tight over the whole, 
Old sores that are difficult to heal may be much bene- 
fited by the application of long strips applied in such 
a manner as to draw the sides nearer together, especi- 
ally if bathed twice or thrice a day with a wash made 
by dissolving a drachm or a teaspoonful of White 
Vitriol, (No. 41,) in a pint of fresh water. 

No. 33. BLISTER PLASTER. 

Should be spread even upon leather, firm muslin, or 
linen, or upon strong brown paper, of the size of the 
blister desired. The plaster may remain from six to 
twelve hours. Let the part be previously rubbed with 
spirits of turpentine. When the blister rises, let out 
the water, and dress with Basilicon, (No. 30,) if you 
wish the blister to remain open, or Turner's Cerate 7 
(No. 29,) if you wish it to heal soon. 

In pleurisies and other inflammatory diseases,, blisters 
should in general not be applied until after- b]ood 
has been taken. Blisters should not be applied to the 
liead itself, but to the nape of the neck, or to the 
shoulders. They sometimes affect the Madder, and 
prevent a free discharge of urine. This may be pre- 
vented by sprinkling over the plaster a little powdered 
camphor, or relieved by a dose of Laudanum, (No. 16,) 
Spirits Nitre, (No. 20,) or by drinking flaxseed tea or 
barley water freely. 

No. 34. STRENGTHENING PLASTER. 

Applied to strains, rheumatic pains, pains in the side 
or breast. It should be spread on leather. 

No. 35. LINT, 
Is applied as a soft dressing to wounds y and over ad- 
hesive plaster, to absorb the discharges. It may be 
spread with basilicon or other cerate, which will make 
the next dressing of the wound much easier. Care is 
to be taken in spreading cerate upon lint, to spread it 
lengthwise of the threads. Where lint is applied dry 7 
it should be soaked off with warm water at the next 
dressing. 



19 

No. 36. CHAMOMILE FLOWERS, 
Are a very useful stomach bitter. They are more 
grateful in the form of cold infusion made by letting 
cold water remain on them a few hours. Dose, a wine 
glass three or four times a day. In this way persons 
whose digestion is weak from long residence in hot 
climates, from excessive drinking or other causes^ will 
find them useful. 

Warm chamomile tea is generally used during the 
operation of an emetic, and will be found useful in 
cramps of the stomach, in spasmodic and wind cholic, 
in all those sudden attacks of fever in summer and 
autumn. It will oftentimes check that vomiting which 
arises from disease, in cholera morbus, &c. Chamo- 
mile flowers are sometimes used in hot fomentations, 
to relieve pain and promote suppuration, or the forma- 
tion of matter. 

No. 37. FLAXSEED. 
An excellent soothing tea is made by boiling two 
tablespoonsful a few minutes in a quart of water? 
which may be drank freely in colds, hoarseness, 
coughs, pleurisies, pains in the kidneys, and in scald- 
ings of the urinary organs. 

No. 38. ARROWROOT. 
A nutritious unirritating article of diet for sick per- 
sons. (See Recipes, p. 29.) 

No. 39. RED PRECIPITATE, 

Is principally used to sprinkle sores, to eat away 
fungus or proud flesh, or upon old sores to promote 
the discharge of healthy matter. 

No. 40. BLUE VITRIOL. 

Used for the same purpose as (No. 39.) 
No. 41. WHITE VITRIOL, or SULPH. ZINC, 
Is a very speedy vomit ; hence it is the best emetic 
in cases of poisoning. Dissolve 30 grains, or the con- 
tents of one of the papers, in four tablespoonsful of 
water, and take one every ten minutes until free vom- 
iting ensues. It is equal to Quinine in fever and ague, 



20 

and one or two grains may be combined with a few 
grains of Cayenne pepper, and administered every 
three hours between the fits, and the same dose three 
times a day to prevent their return. A piece equal to 
the size of a duck-shot perhaps is a sufficient measure 
for a dose where scales and weights are not at hand. 
A drachm or an even teaspoonful, dissolved in a pint 
of fresh water, makes an excellent wash for old sores 
or proud flesh in unhealthy wounds. This is also 
suitable for injection in the very earliest stage of the 
clap, and after the running has continued for a long 
time. White vitriol is also an excellent tonic in the 
latter stages of typhus fever, and during convalescence^ 
and can be taken a long time without injury. (See 
Tonic Solution, under the head of recipes.) The 
tonic solution is well adapted to check bleeding from 
the stomach or lungs. Dose, one or two teaspoonsful 
every hour or two. It makes a good gargle in putrid 
sore throat. 

No. 42. SUGAR OF LEAD. 
May be used in all cases where extract of lead is 
useful. A drachm or a teaspoonful to a pint of water 
makes lead-water, or a proper wash for sores and 
for injection into the urethra. Linen cloth and lint 
dipped in it may be applied to burns^ inflammations, 
and gun-shot wounds. These applications should be 
frequently repeated. For inflamed eyes the wash 
should be but half this strength. Sugar of lead is one 
of the most prompt remedies for inward bleeding, 
such as from the lungs, stomach, womb, nose, &c, 
that can be administered. It should always be guard- 
ed by laudanum or opium, two or three grains mixed 
up into a pill, with a quarter to a half grain of opium, 
or in powder with ten or twelve drops of Laudanum, 
(No. 16,) mixed with molasses every half hour until 
the bleeding ceases. Within six hours from the first 
dose, let the patient take a moderate dose of Castor 
Oil, (No. 12.) Half a drachm to one drachm finely 
powdered, and thoroughly mixed with about an ounce 
of lard, or two tablespoonsful of sweet oil, is an excel- 
lent application to external piles. 



21 

No, 43. ALUM, 
A strong solution of alum, either with or without 
the mixture of linseed or sweet oil, is the "best appli- 
cation to recent burns that I have ever used. Cloths 
or Lint, (No. 35,) dipped in the solution, should be 
laid upon the burn, and repeated as often as they get 
dry. Alum may be used for internal bleedings, and in 
diarrhoea after a cathartic. In painters' and bilious 
cholic, with obstinate constipation of the bowels, ten 
©r twenty grains repeated every six or eight hours ? 
duly persisted in, prove gentle laxatives, and mitigate 
the pain. (See Tonic Solution, p. 30.) 

No. 44. POWDERED KINO. 

An astringent for diarrhoea, the latter stages of go- 
norrhea, and for gleet. It is peculiarly useful in the 
diarrhoea of Canton, and other hot climates, where the 
patient has little or no fever. Each paper contains 
fifteen grains, to be taken in molasses three or four 
times a day. The dose can be doubled if necessary. 

No. 45. ANTIMONIAL, FEVER POWDER. 

Long known by the name of James' Powders. — It 
is an excellent medicine in all bilious and inflammatory 
fevers. In colds, coughs, pleurisies, and almost all 
other fevers, it is useful to promote perspiration, es- 
pecially when followed by warm, mild drinks, as 
boneset tea, hot lemonade, &c. 

Antimonial tartar emetics, and fever powders in 
typhoid or low nervous fevers, should very rarely be 
used, on account of their debilitating effects. Dose, 6 
grains ; for children, 2 to 4 grs. 

No. 46. DOVER'S POWDERS. 
Long known as a medicine to promote perspiration^ 
relieving rheumatic and other pains, quieting restless- 
ness and inducing sleep. Many persons who cannot 
take either solid opium or laudanum are able to bear 
opium, as combined in Dover's powders. They may 
be used in typhus and bilious fever, rheumatism, and 
latter stages of pleurisy, and in coughs and colds. 
Should the tongue be dry in the morning, where this 



22 

medicine has been administered the night before, it 
should be omitted. 

Ten grains contain one grain of opium. Dose, from 
10 to 15 grains, for an adult. 

No. 47. IPECACUANHA, (EMETIC,) 
Is a much milder vomit than tartar emetic, and is 
perfectly safe, as it does not act with violence nor con- 
tinue its emetic operation, unless continually admin- 
istered. It is suitable in feeble habits, and sinking 
diseases, when an emetic is indicated. It is proper to 
administer Ipecac, in severe colds, diarrhoea or dysen- 
tary. It may be continued in the dose of from one- 
eighth of a grain, or a little upon the point of a pen- 
knife, to half a grain, every three hours, in water or 
molasses, in those diseases, and for bleeding from the 
lungs, cough and asthma. It is useful to check vom- 
iting that arises from a foul stomach, &c, given in 
vomiting doses. 

Dose, thirty to forty grains. For a child under 
twelve years of age, six to fifteen grains. Each paper 
contains thirty grains. Mix the Ipecac with a little 
boiling water, then add 6 tablespoonsful more. Take 
half the dose at the first draught, and a tablespoonful 
every ten minutes until it operates freely. Sometimes 
two grains or one third of a paper of Tartar Emetic, 
(No. 1,) may be advantageously united with it. 
For children let a teaspoonful be substituted for a 
tablespoonful. 

No. 48. QUININE, 
Is known more particularly as a remedy in fever 
and ague. Dose, one grain to three or even five grains 
every three hours before the chill. The same dose 
should be continued three times a day to prevent the 
return of the disease. An emetic or cathartic should 
precede the use of the quinine. It is also an excellent 
strengthening medicine after a fever has subsided, and 
left the patient weak, in loss of appetite, and in general 
debility, where the tongue is not coated with fur. 
Each paper contains one grain, and may be dissolved 
in four or five drops of elixir vitriol. Children may 
take a fourth of a grain, to one grain. 



23 

No. 49. BONESET, or THOROUGHWORT, 
Made into a strong tea, and drank largely, is emetic J 
half a tumbler every three hours before the cold fit of 
fever and ague, will oftentimes cure the disease. 
,Boneset tea, weak, may be drank freely, during the 
cold and hot fits, where there is not excessive inflamma* 
tory excitement, and in colds to promote perspiration. 
Boneset is an excellent tonic for dyspepsia, in the form 
of cold infusion made by pouring cold water to a small 
quantity of the herb. Dose, half a tumbler three times 
a day. 

No. 50. SALTPETRE, or NITRE, 
In the dose of fifteen or twenty grains, or half a 
teaspoonful dissolved in a little cold water, and drank 
immediately once in two or three hours, relieves fever. 
Two parts each of Cream of Tartar, (No. 10,) and of 
Sulphur, (No. 9,) with one part of powdered nitre 5 
form an efficacious remedy in obstinate claps and gleets. 
Dose, one teaspoonful three times a day. A teaspoon* 
ful of cubebs, when they can be procured, added to each 
dose, renders this compound still more efficacious* 

No. 51, SYRINGE. 
No. 52. LANCET. 



SECONDARY LIST. 

The following described medicines are added for 
general use on shore, as they can be procured at any 
time from the apothecary, and for the larger packet 
ships. They are prescribed in this edition mostly as 
additional remedies to those numbered in the previous 
pages, and are not to be expected in ordinary medicine 
chests unless particularly ordered. 

SULPHATE OF MORPHINE. 

This article is a chemical preparation of opium, and 
bears the same relation to it that quinine does to 



Peruvian bark. It contains the narcotic or soothing 
principle of laudanum or opium, and can be employed 
in a great proportion of cases where crude opium 
produces uncomfortable symptoms. The dose for an 
adult is from one eighth of a grain to half a grain. It 
may be given in powder or solution. The latter may v 
be formed by dissolving one grain in three or four 
drops of Elixir Vitriol, (No. 14,) and mixed with an 
ounce of water. One teaspoonful of the solution con- 
tains one-eighth of a grain of morphine, equal to about 
fifteen or twenty drops of laudanum. 

GUM ARABIC. 
The preferable form of this article is the powder, as 
it is more conveniently added to various mixtures and 
solutions, and is used in medicine chiefly as a demul- 
cent in coughs and other irritations of the lungs ; in 
diarrhoea, combined with other medicines or by itself 
in solution, in inflammatory affections of the lining 
membranes of the lungs, stomach, bowels, kidneys, 
bladder, &c. It is an unirritating and nourishing 
article of diet. An ounce of the gum boiled in a pint 
of water may be used both as food and drink of the 
patient. 

ESSENCE OF CINNAMON, 
This article is designed to cover the unpleasant 
taste of medicines and is more agreeable to many 
persons than the essence of peppermint. It is useful, 
also, to relieve wind in the stomach and bowels * 
With rhubarb and magnesia it modifies their action in 
diarrhoea and other complaints. It enters into the com« 
position of the well known " Chalk Mixture." 

OPIUM AND OPIUM PILLS. 
It is occasionally desirable to give opium in its solid 
state, instead of either laudanum or morphine. In 
inflammatory affections, before bleeding, it should 
rarely be given in any form. In affections of the' brain 
and of the lungs, with quickened pulse and dry cough, 
never. In cholic and cholera morbus it is preferable 
to laudanum or Dover's powder^ for if it is rejected 



25 

from the stomach it may he seen, and the succeeding 
administration of it regulated accordingly. A pill of 
opium introduced into the fundament, in diarrhoea, 
has the same effect to control the discharges as the 
anodyne injection of starch and laudanum. The sys- 
tem will bear four times the dose thus administered 
that can be given by the mouth. Onium pills should 
be one grain each. 

COMPOUND TINCTURE OF RHUBARB. 

This is a favorite remedy of many persons for 
diarrhoea. It is, however, objectionable from the 
amount of spirit it contains. It should not be admin- 
istered in any case where inflammatory action or fever 
exists, nor to a reformed inebriate, lest he may suffer 
a relapse to his former habits. One or two tablespoons- 
ful is a laxative dose for an adult. One or two tea- 
spoonsful before eating is a good stomachic in flatulency 
and indigestion. 

UVA URSI, OR BEARBERRY LEAVES. 

This plant is an excellent remedy for a variety of 
urinary and dropsical complaints. In gravel, com- 
bined with gum arabic and cream of tartar, the uva 
ursi more speedily produces relief than anything I 
ever tried. It is a proper remedy in strictures or sup- 
pression of urine. In all stages of Gonorrhoea, especially 
in the latter stages, the above combination is a valua- 
ble remedy. In bloody urine, chronic inflammation 
of the bladder, and in dropsy, it is a safe and effica- 
cious remedy. It may be thus prepared. Pour upon 
an ounce of the leaves, one ounce of gum arabic, and 
half an ounce of cream of tartar, a pint of boiling 
water. After simmering gently for five or ten minutes, 
stir it up that the gum may be well dissolved, pour it 
off and sweeten with sugar. Dose, a wine glass three 
or four times a day. During an attack of gravel, or 
obstruction of urine, the dose may be repeated every 
half hour. 

3 



26 

HYDRIODATE OF POTASH. 

^ This medicine is sometimes called Iodide of Potas- 
sium, and is a combination of iodine and potash. It 
has come into extensive use within a few years for 
scrofulous and a great variety of other complaints. It 
is administered internally in the form of solution in 
water, and externally as an ointment. The solution is 
made by dissolving one drachm in a pint of water. 
Dose, two large spoonsful three times a day. This 
dose may be safely doubled. To form the ointment, 
dissolve a drachm in one or two teaspoonsful of water, 
and rub it up with an ounce of lard or simple cerate. 
In rheumatic affections hydriodate of potash is the 
most satisfactory remedy I ever used. Three ounces of 
Opodeldoc, (No. 23,) combined with an ounce of tinct. 
of iodine, or four ounces of the opodeldoc combined 
with a drachm of the hydriodate, dissolved as for 
making the ointment, forms an excellent liniment to 
promote the absorption of swellings that are not in- 
flamed, to relieve white swellings, rheumatism, &c. 
It should be administered internally at the same time. 
In nocturnal pains, and after a course of mercury, it is 
a very valuable remedy. The decoction, or syrup of 
Sarsaparilla is an excellent assistant in all these com- 
plaints. A variety of skin diseases give way under 
the continued use of this remedy. In bad constitutions, 
subject to ulcers, and in what is called a bad state of 
the blood, it may be used in most cases with signal ad- 
vantage. Two or three cases of habitual costiveness 
were cured by a daily use of the solution for a short 
time. It is a proper remedy in female complaints, as 
leucorrhcea or whitesj suppression of the monthly dis- 
charges, &c. 

SUPER. CARBONATE OF SODA. 

This article, with tartaric acid, forms the well-known 
soda powders. The blue paper contains the soda, and 
the white the acid. A teaspoonful of soda dissolved 
in a tumbler of cold water forms a solution of suitable 
strength for heartburn or sour stomach, one-fourth of 
which is a proper dose* Five or ten grains rubbed 



21 

with the ordinary dose of Rhubarb and Magnesia, as- 
sists and modifies their operation. Buckwheat and 
other fried cakes are rendered much more digestible 
by the addition of a little soda. The yeast powders 
found in the shops are composed of about two tea- 
spoonfuls of Super. Carb. Soda, and in the white pa- 
pers one teaspoonful of tartaric acid. 

TINCTURE OF MYRRH. 

All the virtues of gum myrrh are contained in the 
tincture. It strengthens the stomach and the system 
generally. It is a common remedy in female complaints, 
and in the form of a wash mixed with water, for foul 
ulcers, and for the teeth and gums. Dose, from forty 
drops to a teaspoonful, in water. 

MURIATED TINCTURE OF IRON. 

This and all other forms of iron are excellent tonics 
or strengthening medicines, especially in female com- 
plaints. The tinct. of iron is used most frequently in 
urinary complaints. It is particularly useful in sup- 
pression of urine that arises from spasm. Given in 
doses of from ten to twelve drops every ten or fifteen 
minutes, it sometimes procures prompt relief in the 
most obstinate cases. It is a good remedy in excessive 
menstruation, in leucorrhoea or whites, and in the latter 
stages of gonorrhoea and gleet, in bloody urine, and ir- 
ritation of the neck of the bladder, where there is no 
fever. Dose, ten to twenty drops. 

OIL OF CLOVES. 

This is a perfectly safe remedy for tooth-ache, better 
than Creosote. The latter, in one case known to the 
author, destroyed life by being accidentally swallowed. 

POWDERED CUBEBS. 

Used chiefly in gonorrhoea, in the dose of a teaspoon- 
ful three times a day. 

LUNAR CAUSTIC. 

Is used to destroy proud ilesh in ulcers, warts, and 
other small excrescences. (See Venereal Diseases.) 



E E C I P E S. 



DECOCTION OF BARK. 

To an ounce, or about four tablespoonsful of bark, 
add one and a half pints of water ; boil slowly in a 
covered vessel ten minutes : strain while hot, and set 
it by to cool. The dose is from half to a whole wine- 
glass full, repeated occasionally, or at intervals, with 
one or two teaspoonsful of tincture of bark (No. 25.) 
It will not keep long, and should be made fresh every 
day. 

INFUSION OF BARK. 

Take the same quantity of bark as in the preceding 
article ; add a pint of water and a gill of brandy ; let 
them stand for 24 hours, and pour off the pure liquor. 
This keeps better than the decoction, and is an elegant 
form of exhibiting the bark when the stomach is weak 
and delicate. It is used principally in indigestion, in 
doses of a wine-glassful, twice or thrice a day. 

VOLATILE LINIMENT. 

Take the spirits of hartshorn, two parts, olive or 
castor oil, three parts ; mix them together. This lini- 
ment, applied to the throat and neck with a piece of 
flannel over it, is very efficacious in relieving soreness 
and inflammation in these parts. It is also a good ap- 
plication for rheumatic and other pains. 

MUSTARD POULTICE. 

Take some pounded bread, or Indian meal, and boil 
it a few minutes in water, spread it thick upon a cloth, 
and sprinkle on it powdered mustard ; or if great haste 
is required, mix up some mustard in vinegar and water 
and spread thin upon linen or muslin cloth, and apply 
it to the part. If the plaster is left long upon the skin 
it occasions a troublesome blister. 



29 

TAR WATER. 

Take of tar one pint, water one gallon ; boil them 
together fifteen minutes, frequently stirring them; 
afterwards pour off the water for use. This is a valu- 
able application for the piles. 

POULTICES FOR SORES AND INFLAMMATIONS. 

Take of Indian meal, or pounded bread and pounded 
flaxseed, equal parts, boil them together fifteen or 
twenty minutes, and spread the mixture more than 
half an inch thick on rags, and apply them warm. 
They should be renewed every three or four hours. 
Poultices may be made likewise of oat or Indian meal, 
rice, or peas, or onions, and in swellings and inflamma- 
tions, white beans and turnips are very good. 

SWEATS. 

Sage and green or black tea, mixed and drank freely, 
and hot lemonade, are good to bring on a sweat ; also, 
boneset, catmint, saffron, mullen, &c. In general, 
sweats are best procured by drinking plentifully of 
weak and warm drinks ; they ought to be continued a 
considerable length of time, and not to be checked too 
suddenly, and care taken against catching cold. 

TOAST WATER. 

Is made by steeping slices of soft fresh bread in 
water, first toasting the bread till browned thoroughly, 
and then putting it into the water while hot. If soft 
bread cannot be had, the hard kind must answer. 

ARROWROOT GRUEL. 

A pint may be prepared by rubbing up a table - 
spoonful of the arrowroot with a little cold water, 
which should be poured into a pint of boiling water; 
add a little salt ; let it boil three or four minutes, con- 
stantly stirring it. It may be sweetened with sugar, 
and a little nutmeg added to it. When milk can be 
procured, it may be used with an equal quantity of 
water. 

3* 



30 

TONIC SOLUTION. 

Take of White Vitriol, (No. 41,) three drachms, or 
two teaspoonsful slightly rounded, Alum, (No. 43,) 
one drachm, or a piece as large as a moderate sized 
chestnut, hot water, one pint. 

An excellent remedy in fever and ague, dysentery, 
diarrhoea, debility, loss of appetite, in the dose of a 
teaspoonful several times a day. 20 to 40 drops for a 
child thrice a day. A speedy emetic in the dose of a 
tablespoonful in . case of poisoning, and in the com- 
mencement of fever and ague. 

COUGH DROPS, (No. 1.) 
Take Paregoric, No. 13 ' 

Fryar's balsam, 15 

Spirits nitre, 20 ^ equal parts. 

Syrup squills, 22 | 

Antimonial wine, 28 J 

Sweeten with honey, sugar, or molasses. Dose, one 
or two teaspoonsful several times a day. 

COUGH DROPS, (No. 2.) 
The following is the best expectorant mixture I have 
ever known for recent colds, hoarseness, or long stand- 
ing coughs. The prescription can be obtained of any 
respectable druggist : 

Tincture of cohosh, ^ 

" of bloodroot, I 

ISotfSe, U-lpart, 

Syrup of squills, , 

Syrup of tolu, J 

Dose from one to two teaspoonsful frequently. Sy- 
rup of Ipecac, in some cases, will be found to agree 
better than the antimonial wine. 

EYE WATER. 
Take Sugar of Lead, (No. 42,) 16 grs. 
White Vitriol, (No. 41,) 12 grs. 
Dissolve each article separately in half a tumbler of 
water. Mix the two solutions, pour off the clear liquor, 
and drop a few drops into the eye thrice a day. 



31 

PURGING, or LAXATIVE INJECTION. 

Common salt, two large spoonsful : water, one pint 5 
molasses, one gill; mix. In case there is obstinate cos- 
tiveness, add from a wine-glass to a gill of spirits of 
turpentine. 

ANODYNE INJECTION. 

This injection is intended to check frequent dis- 
charges in diarrhoea. A pill of opium inserted into the 
anus will produce the same effect. 

Thin flour starch, half a tumbler, laudanum from 40 
drops to a teaspoonful for an adult 3 mix. 

Pour the above into the syringe, and turn the point 
of the pipe upward, and push up the piston or handle 
until the starch appears at the point, when all the air 
will be excluded. Gently push up the contents of the 
syringe, and repeat the dose when the first comes 
away, for frequent and slimy stools in dysentery and 
diarrhoea. Four times the quantity of laudanum can 
be given by injection that is taken by the mouth. In 
those diseases where the patient's strength is much re- 
duced, and nourishment cannot be retained upon the 
stomach, injections of fat broths, gruel, barley water, 
or beef tea, (without any salt,) will often support them 
a long time. They may also be used in other cases 
where a simple injection is wanted.* 

SEIDLITZ POWDERS. 

Dissolve two heaped teaspoons of Seidlitz mixture 
in two -thirds of a tumbler of cold water, and stir in an 
even teaspoonful of tartaric aid, and drink immedi- 
ately. 

SODA POWDERS. 

The same quantity of tartaric acid dissolved in about 
a wine-glass of cold water and a teaspoon slightly 
heaped of the super-carbonate of soda in half a tum- 
bler more ; mix the two solutions and drink immedi- 
ately. This is cooling, refreshing, and checks vomit- 
ing, &c. Seidlitz and soda powders put up in bottles, 
and used as above directed, will be kept always good. 



32 

ALUM WHEY. 

Boil a drachm or a teaspoonful of powdered alum in 
a pint of milk a few minutes. Strain off the whey 
and give a teacupful three or four times a day. 

CHALK MIXTURE, 
Is a useful medicine in simple diarrhoea, or looseness, 
and may safely be given in all cases where there is 
little or no fever, and the purging is unaccompanied 
with severe griping. It is thus prepared : — take of pre- 
pared chalk, one ounce and a half ; white sugar, one 
ounces powdered gum arabic half an ounce; oil of 
cinnamon, twelve drops. Rub them together. Dose, 
a teaspoonful in a wine-glass of water every two hours 
for an adult, and half that quantity for a child. Or 
the whole may be mixed at once with a pint and a 
quarter of cold water and given as above, always 
shaking the medicine before using. A drachm of pow- 
dered kino, (No. 44,) in severe cases, may be added to 
the mixture, and sixty drops of laudanum, (No. 16,) or 
six drops to a dose for grown persons. The dose for 
children must be varied from half a drop to two drops 
of the laudanum, according to age. 

DEWEES' VOLATILE TINCTURE OF GUIAC. 

Take of coarsely powdered gum guiac, 4 ounces; 
cubebs bruised, 1 ounce; super, cart), soda, or saler- 
atus, lj drachms; hartshorn, (No. 17,) £ ounce; com- 
mon spirits, a pint. Let it stand ten days, occasionally 
shaking the bottle. An excellent remedy in dyspepsia, 
loss of appetite and female complaints. Dose, one or 
two teaspoonsful, three times a day, in sweetened milk 
or water. (See Female Diseases.) 

MYRRH MIXTURE. 
Take of gum myrrh, 3 drachms; copperas, 1 scruple : 
sup. carb. of soda, Ik drachms; white sugar, 1 ounce; 
1 large nutmeg; oil of anise, or mint, 10 drops. Let 
the articles be powdered coarsely, either separately or 
mixed. Put them into a bottle. Having warmed the 
bottle previously, to prevent its breaking, pour upon 



33 

the medicine three-fourths of a tumbler of boiling 
water. Cork the bottle immediately. After standing 
not less than half an hour, add half a tumbler of alco- 
hol. Dose, a tablespoonful three times a day, with as 
much water. This is a valuable remedy in dyspepsia, 
in female complaints, &c. ; an excellent tonic in con- 
sumption, and debility from long continued nursing, 
&c. 

FEMALE PILLS. 

R. Powdered bloodroot, |ss. 

" sulphate of zinc, 5j- 

u aloes, 3j- 

•Make up into common sized pills with mucilage of 
gum arabic for suppressed menstruation. 

Dose, one pill three times a day for a month, unless 
the desired effect is produced. 

FAMILY PILLS. 

In this day of quackery and imposition, the public 
are induced by flaming advertisements and fictitious 
certificates, to patronize some of the most ordinary 
prescriptions and swallow injurious pills in large quan- 
tities. To prevent this, in some degree, I have been 
induced to present the following formula. It makes an 
excellent pill for family use. It neither sickens nor 
gripes the patient, but operates effectually, yet very 
mildly. Whoever tries them once will be disposed to 
use them afterwards, if occasion requires. Any apothe- 
cary can make them up. 

R. Aloes, 6 parts. 

Scammony 3 " 

Gamboge, 1 " 

Make into five grain pills with a little water. Dose 
one pill as a laxative, three or four for a purge. 



34 



GENERAL RULES 

FOR THE PREVENTION OF DISEASES AMONG SEAMEN. 

1 . Avoid the use of ardent spirits, even in moderate 
quantities. Strong drink invariably predisposes to dis- 
ease. 

2. Use tobacco sparingly, if at all. It never defends 
from disease, and a free use of it deranges the powers 
of the stomach, induces trembling, and increases the 
susceptibility to every indisposition. 

3. Pay strict regard to cleanliness of person and 
clothing ; let the vessel also be kept clean, well ventil- 
ated, and as dry as possible. 

4. Use the purest water, and eat freely of vegetables, 
especially in long voyages. Keep the bowels open. 

5. Observe regular hours for sleep ; and let it not be 
indulged on deck, or on the shore ; especially if the 
season be warm and the seamen are unused to the 
climate. 

6. Keep the dress as dry as possible, and adapt it to 
the temperature of the climate. It is generally best to 
wear flannel next the skin. 

7. Correct the moisture of the lodging apartments 
every evening, by a fire in the stove. 

8. Select anchorage to the windward of the land. 

9. If disease of a fatal character be already aboard, 
separate the well from the sick ; and in case of death, 
the clothes of the diseased should be thrown over- 
board with the body. If the hammock be retained, it 
should be smoked and thoroughly washed. Let the 
vessel, or sick-room, be frequently aired, and, on the 
death or recovery of a patient, fumigate the apartment 
in which he was confined by burning on a hot shovel 
or iron, nitre, or charcoal and sulphur. Sprinkle with 
hot vinegar, and whitewash the apartment, or scatter 
about the room chloride of lime. 



35 



GENERAL RULES 

FOR THE TREATMENT OF DISEASES. 

In many cases of illness, where the attack is not very 
severe, a proper attention to diet and habits is all that 
will be necessary. Abstinence from food and stimu- 
lating drinks, living on gruel and other liquid food, will 
give the system an opportunity to recover itself. In all 
cases of indisposition, especially attended with fever, 
the " antiphlogistic regimen," as it is called, ought to be 
observed. By this is meant the taking away of every- 
thing that may stimulate the system, or excite fever, so 
far as this may be done safely. Impressions upon the 
senses, particularly the sight and hearing, bodily and 
mental exertion, &c, must be guarded against as much 
as possible. The diet should be of the most sparing 
kind ; barley water, thin Indian gruel, toast water, &c, 
with some acid, such as lemons, Cream of Tartar, (No. 
10,) dissolved in it, or small doses of Nitre, (No. 50,) 
from time to time in water, to quench the thirst and 
cool the body. All animal food, and fermented and 
distilled liquors, should be withheld ; the clothing must 
be light, the apartments must be well aired. 

Rule i. 

In every complaint, whatever it may be called, if 
you find the pulse quick, and strong, — head-ache, — 
tongue foul, — skin hot, or those marks which denote it 
of an inflammatory nature, remember the plan is to re- 
duce it by bleeding, — purging, — low diet, — drinking 
plentifully of cold water and lemonade, — rest, &c. 

Rule ii. 

If, on the contrary, the pulse be small, soft, feeble 
and intermitting, — the tongue dark, and great debility 
or weakness is evident, reverse the whole plan; the 
diet must be generous and nourishing, — the bowels 
opened with gentle laxatives, — and the strength sup- 



36 

ported by bark, sulphate of quinine, wine and tonics of 
various kinds. 

Rule hi. 

If in addition to those symptoms mentioned in the 
second rule, the tongue be covered with a black coat. 
• — foul, dark looking sores form about the gums and 
insides of the cheeks — the breath be offensive, &c, the 
same class of remedies is to be vigorously employed, 
with a free use of acids and other antiseptic articles, or 
medicines, to prevent putrefaction. 

Rule iv. 

Severe local pains, as in the head, side, &c, require 
the use of the lancet, purging and blister to the part. 

Rule v. 

Incessant and earnest entreaties on the part of the 
sick, for any particular article of diet, if steadily perse- 
vered in, may be safely indulged, whether the use of it 
agrees or not with our preconceived ideas on the sub- 
ject. 

Rule vi. 

In all fevers, where the pulse is quick, full, and 
strong, the skin burning to the touch, and there is no 
perspiration, dash cold water over the head and shoul- 
ders of the patient, wipe him dry, and put him to bed. 
If in consequence of this a chill be experienced, and 
the pulse sink, give warm wine, &c, and omit the wa- 
ter for the future. Should a pleasant glow over the 
whole frame follow the affusion, and the patient feel 
relieved by it, repeat it as often as may be necessary. 

Rule vii. 

Observe carefully the effects of various articles of 
food, as well as physic, upon your own body, and 
choose those which experience proves to agree best 
with you. 

&f- Bathing the feet in warm water is proper and 
advantageous in all febrile attacks. It relieves head 
ache and assists in promoting perspiration. 



MEDICAL PRACTICE. 



The reader of this Manual will find various symp- 
toms described as belonging to each disease, but he 
must not expect to find every symptom in every case of 
that disease he may be called to prescribe for. He 
must make up his judgment from the general symptoms. 
It is very rare that we find now a case of pleurisy with 
all the symptoms mentioned as belonging to that dis- 
ease. It must not be supposed, that every attack can 
be accurately named. There are certain medical prin- 
ciples embodied in the ''General Rules" of the previous 
page, that may be applied to a great many particular 
cases, where no particular name can be given to the 
diseass. 

OF THE PULSE. 

The pulse is nothing more than the beating of an 
artery. There are two kinds of blood-vessels in the 
body: arteries and veins. The arteries carry the blood 
from the heart to the extremities of the body, where 
they are connected with the veins which bring it back 
again. An artery pulsates or beats • a vein does not. 
Every time the heart contracts, a portion of blood is 
forced into the arteries, which dilate or swell to let it 
pass, and then immediately regain their former size, 
until by a second stroke of the same organ, a fresh co- 
lumn of blood is pushed through them, when a similar 
action is repeated. This swelling and contracting of 
the arteries, then, constitute the pulse, and consequently 
it may be found in every part of the body where those 
vessels run near enough to the surface to be felt. Phy- 
sicians look for it at the wrist, from motives of conve- 
nience. 

The strength and velocity of the pulse vary much in 
different persons, even in a state of perfect health. It 
is much quicker in children than in adults ) and in old 
4 



38 

men it grows more slow and feeble, owing to the de- 
creased energy of the heart. The pulse is increased 
both in strength and velocity by running, walking, 
riding, and jumping; by eating, drinking, singing, 
speaking, and by joy, anger, &c. It is diminished in 
like manner, by fear, want of nourishment, melancholy, 
evcessive evacuations, or by whatever tends to debili- 
tate the system. 

In feeling the pulse, then, in sick persons, allowance 
should be made for these causes, or what is better, we 
should wait until their temporary effects have ceased. 

A full, tense, and strong pulse, is when the artery 
swells boldly under the finger, and resists its pressure 
more or less ; if, in addition to this, the pulsation be 
very rapid, it is called quick, full, and strong ; if slow, 
the contrary. 

A hard, corded pulse, is that in which the artery feels 
like the string of a violin, or a piece of tightened cat- 
gut, giving considerable resistance to the pressure of 
the finger. 

The soft and intermitting pulses are easily known 
by their names. In cases of extreme debility, on the 
approach of death, and in some particular diseases, the. 
artery vibrates under the finger like a thread. 

In feeling the pulse, three or four fingers should be 
laid on it at once. The most convenient spot to do 
this, as already mentioned, is the wrist ; but it can be 
readily done on the temple, — just before, and close to 
the ear, — in the bend of the arm, — at the under part of 
the lower end of the thigh, — among the ham-strings, 
and on the top of the foot. 

OF FEVER. 

Fever is, by far, the most common complaint to 
which the human body is subject. It may be briefly 
described as a combination of heat, thirst, loss of ap- 
petite, weakness, and inability to sleep. It makes its 
appearance in two ways : either suddenly and violently, 
or gradually and gently. When it comes on in the first 
manner, a cold shaking, attended with sickness at the 
stomach, or vomiting, marks its access; the cold is more 



39 

severe than in the latter, as is also the pain in the head, 
and other symptoms. When its attack is gradual, a 
feeling of soreness over the whole hody, such as is ex- 
perienced after a hard day's work by one not accustom- 
ed to it, shows its approach. Nausea, pains in the 
head, chills, and more or less heat and thirst, soon fol- 
low. 

As these symptoms vary infinitely in their degrees of 
violence, the vigor of the treatment to be pursued must 
differ accordingly. Thus the same directions that are 
given for simple inflammatory fever must be adhered 
to, in one whose symptoms are lighter, though similar, 
only there is no necessity for pushing them to so great 
an extent. 

INTERMITTENT FEVER, or FEVER AND AGUE. 

There are three kinds of this disease. 1st — The 
Quotidian, the fits coming on in the morning of every 
day. 2d — The Tertian, commencing in the middle of 
the day, and returning every third day. 3d — Quartan, 
the fits coming on in the afternoon of every fourth day. 
The treatment of every form is so similar, that one ge- 
neral mode answers for all. 

Symptoms. — Intermittent fever begins with a sense of 
weakness, weariness, pulse small and quick, pain in 
the back and loins, head-ache and drowsiness, some- 
times sickness of the stomach and vomiting, excessive 
chilliness and shaking. To these succeed great heat 9 
the tongue is white and dry, pulse hard and strong \ a 
profuse sweat terminates the fit. 

Treatment. — In general an Emetic, (No. 1,) or a 
dose of Calomel and Jalap, (No. 2,) should commence 
the treatment. Then give, every three hours before 
the chill, a grain of Quinine, or the contents of one of 
the papers, (No. 48,) or a teaspoonful of Bark, (No. 
11,) or one or two grains of White Vitriol, (No. 41,) in 
molasses, with a few grains of Cayenne pepper, or 
ginger, or cloves, or nutmeg. At the present time, phy- 
sicians generally prefer Quinine, doses from three to 
five grains, and in African and other tropical fevers 
even larger doses still. 



40 

White vitriol is nearly as efficacious as quinine. It 
is best to commence its use in an emetic dose, and con- 
tinue it in the dose of one or two grains, either with or 
without the spices, three times a day, to prevent the 
return of the fits. Weak tea of Boneset, (No. 49,) may 
be drank freely during both the cold and the hot stage, 
if there is no great febrile excitement. If the disease is 
not broken up at the first, the medicines must be con- 
tinued as before ; as soon as the sweating has subsided, 
except in the third or quartan form. Medicines need 
not be commenced in this variety until twelve hours 
before the expected attack of the chills. 

A strong decoction of boneset in the dose of a wine- 
glass or more, or a few grains of Alum, (No. 43,) and 
powdered nutmeg, every three hours, will frequently 
cure the disease when the best remedies seem to have 
no power. 

Some physicians prefer giving a single dose of five 
grains of quinine one hour before the chill. A Dover's 
Powder, (No. 46,) given in the cold stage, or half an 
hour after the hot fit commences, will frequently be 
found an effectual remedy. Bathing the feet in warm 
water, both in the cold and hot stage, relieves the head 
and shortens these stages. 

REMITTING BILIOUS FEVER. 

Symptoms. — This disease differs from the fever and 
ague, in having no regular intermission, and by a 
greater frequency of delirium. When the fever de- 
creases in violence, as it does at a certain time daily, 
and goes off by a gentle moisture, and shortly after re- 
turns, the interval is called a remission. 

Treatment. — If the patient is of a vigorous consti- 
tution, and full habit of body, the pulse full and hard, 
bleed to the extent of a pint, give an emetic of Ipecac, 
(No. 47,) mixed with one third of a paper or two grains 
of Tartar Emetic, (No. 1.) One hour after, give either 
a dose of Calomel and Jalap, (No. 2,) or ten grains of 
Calomel, (No. 3,) and follow the calomel three hours 
after with a full dose of Salts, (No. 8.) If the fever 
continues, give one of the Antimonial Fever Powders, 



41 

(No. 45,) in molasses, every three hours. Let the drink 
be cold water, lemonade, or a solution of Cream of 
Tartar, (No. 10.) Should pain in the head or side con- 
tinue, with a full pulse and flushed countenance, more 
blood may be taken from the arm, and six or eight 
grains of calomel be administered, and worked off by 
salts or Castor Oil, (No. 12.) If much sickness of the 
stomach and vomiting is present, and not relieved by a 
mustard plaster, it may be necessary to apply a blister 
over the pit of the stomach. During the remissions, 
take a teaspoon ful of Bark, (No. 11,) or from one to 
three grains of quinine every two hours. It is proper 
in all fevers to put the feet into warm water, and give 
a weak tea of Boneset, (No. 49,) and to keep the pa- 
tient on a low diet, viz.: water gruel, Arrow-root, (No. 
38,) toast water. The juice of acid fruits, oranges, 
roasted apples, and guava jelly, mixed with water, are 
useful. A very powerful means of subduing fevers is 
the application of cold water, salt or fresh. It may be 
dashed on suddenly from a bucket, or applied with a 
sponge or cloth, whenever the fever runs high, and the 
patient has no chilly sensation, and when he has no 
general or profuse sensible perspiration. From six to 
nine o'clock in the evening is usually the best time to 
apply the cold affusion. Under treatment, this disease 
is sometimes modified into intermittent fever; then it 
should be treated accordingly. 

YELLOW FEVER. 

Symptoms. — Begins with short chills and flushes of 
heat, but not often attended with shakings. Violent 
head-ache, pains in the back and limbs, great debility, 
sickness, and distress at the pit of the stomach ensue, 
with great redness and burning of the eyes. Vomiting 
soon comes on, which is apt to continue, and to end in 
vomiting a dark matter resembling coffee-grounds, call- 
ed black vomit. A yellowness of the skin comes on 
soon, commencing under the ears and extending more 
or less over the surface. The tongue is at first furred 
and moist and trembling, but by degrees becomes black, 
or sometimes of a fiery red color. 
4* 



42 

Treatment. — Let the patient be covered with a 
blanket and take a dose of Calomel and Jalap, (No. 2,) 
or twenty to thirty grains of Calomel, (No. 3,) which 
follow in two or three hours by two ounces or half a 
gill of Castor Oil, (No. 12.) Let him drink freely of 
warm tea of Boneset, (No. 49,) or of sage or catnip, to 
promote sweat. Should the medicine be vomited, let 
the stomach be washed out by frequent draughts of the 
boneset tea. Calomel alone will often be kept down, 
when if combined with jalap it is rejected. An injec- 
tion made by dissolving two large spoonsful of common 
gait and half a gill of molasses in a pint of warm wa- 
ter, should be administered and repeated, until the bow- 
els are thoroughly evacuated. If great febrile excite- 
ment exists, and the patient has a vigorous constitu- 
tion, the loss of a pint of blood at the very beginning 
of the attack may be desirable. 

When the bowels are relieved, the patient should 
continue the warm drinks for the purpose of producing 
perspiration, upon which, in a great degree, his safety 
depends. Should the skin remain hot and dry, bathing 
the feet and legs in warm water, and drinking freely of 
warm lemonade, or boneset tea, will rarely fail to pro- 
duce sweat. The sweat should be continued without 
intermission, until the patient is perfectly free from 
fever, which will generally be the case in forty-eight 
hours. Occasionally sponging the body with warm 
vinegar and water, or what is better, lime juice and 
water, will assist the sweating operations. 

If the head is oppressed, a blister should be applied 
behind the ears or between the shoulders. If the sto- 
mach is disturbed by vomiting, with much anxiety and 
sighing, a blister should instantly be applied over the 
pit of the stomach. If this fails to relieve, dissolve a 
teaspoonful of saleratus in a tumbler of water, and give 
half a wine-glass every half hour. Porter will some- 
times arrest this symptom, when other things fail. 

While these means are used, the feet and hands 
should be kept warm by cloths dipped in hot vinegar 
and water, or spirits and water, frequently renewed. 
Plasters of mustard, meal and vinegar may be applied 



43 

to the wrists, and soles of the feet. In some instances 
blisters applied to the ankles or wrists have arrested 
vomiting, when other means failed. 

The diet should be barley water, Indian gruel, 
arrow-root, &c, and when animal food is first used, 
soup is the best form, with a large proportion of rice, 
barley, and other vegetables. 

The following mode has been found quite successful 
in the hands of a ship-master of my acquaintance : 

He seats the patient in a chair, with a blanket wrap- 
ped around him and the chair, with the exception of his 
head, then sets some convenient vessel under the chair, 
containing half a gill to a gill of spirits, and sets it on 
fire. The steam of the burning spirits produces perspi- 
ration. A second cup may be burnt in the same way. 
The patient is wrapped in the blanket and put into bed. 
Warm teas or lemonade is given him, until free perspi- 
ration follows, and next morning half a tumbler of 
sweet oil. The bowels should be kept open through 
the course of the disease. Peruvian bark, in the dose 
of a teaspoonful, or half a wineglass of the decoction of 
bark, with 15 drops of Elixir Vitriol, (No. 14,) should 
be given every two hours as soon as a remission en- 
sues. A Dovers Powder, (No. 46,) at night, produces 
sleep and perspiration. 

The following, with slight alterations in the phrase- 
ology, is copied from the Philadelphia Medical Exam- 
iner. I presume that similar treatment in African fever 
would be followed by favorable results : 

" When quinine is taken in large doses, medical men 
have observed that it produces but a slight and incon- 
siderable stimulating effect, which is succeeded within 
a few hours by a powerful sedative impression that is 
generally durable. With this view, the medicine is ex- 
hibited in one very large dose of from twenty to sixty 
or eighty grains, in the very beginning of the fever, 
while the morbid action appears in the process of forma- 
tion, that is, within six or eight hours immediately after 
the appearance of the earliest symptoms. It is all im- 
portant, if we understand the theory of its use, that the 
quinine should be employed before local irritation or 



44 

congestion has taken place, that is, while the malady is 
confined to the nervous system and the organization is 
yet unimpaired. 

" When taken under such circumstances its first 
effects are a very slight increase of the febrile symp- 
toms; the pulse perhaps becomes quickened, the 
breathing more hurried, and the usual consequences of 
stimulating medicines are presented. This condition is, 
however, but transient, and is promptly followed by 
corresponding depression. All the more violent symp- 
toms subside, the temperature of the surface is lowered, 
pain diminished ; the pulse is gentle and subdued, the 
skin is covered with a healthy moisture, sleep is 
brought on from which the patient awakes refreshed 
and substantially better, and within twenty-four or 
thirty-six hours is considered in a state of recovery. 
The treatment is of course not exclusively confined to 
the use of the quinine, though this is the chief remedy. 
The usual means of obviating tendencies to local irri- 
tation must be resorted to, as cupping, leeching, warm 
baths, blisters, and other local applications may be used 
according to circumstances. 

" The quinine is administered in a single dose. The 
object is to bring about the sedative or quieting influ- 
ence of the remedy before any other organs, as the 
head, stomach, &c, become specially affected. If it 
should fail to produce the anticipated effect, the case 
is too far advanced for a second trial, and it must be 
treated on general medical principles. Let it, however, 
be remembered, that in thirty or forty cases which have 
been subjected to this novel curative method, not one 
has terminated fatally. The action of the quinine has 
been uniformly most salutary, operating like a charm, 
and dissipating the symptoms of the malady before they 
have become concentrated on different organs." 

INFLAMMATORY FEVER, 

Is a species of fever that rarely occurs in warm cli- 
mates, but is peculiar to cold and temperate climates. 

Symptoms. — It attacks with the usual symptoms of 
■Qther continue 1 fevers, and is shortly followed by red- 



45 

ness of the face and eyes, great restlessness, intense 
heat, unquenchable thirst, oppression of the breathing, 
and sickness of the stomach. The skin is dry and 
parched, the tongue is of a scarlet color at the sides, 
and furred with white in the center, urine red and 
scanty, the body is costive, there is a quickness, full- 
ness and hardness of the pulse, not much affected by 
any pressure upon it. 

Treatment. — The treatment must be very decided, 
blood must be taken from the arm from a large orifice 
to the extent of a pint or a pint and a half. Should 
the inflammatory symptoms continue, repeat the bleed- 
ings. Give full doses of Epsom Salts, (No. 8,) or a 
tablespoonful heaped of Cream of Tartar, (No. 10,) in a 
tumbler of cold water. When the system is somewhat 
reduced, give fifteen grains of Calomel, (No. 3,) instead 
of salts, as a purgative. Dissolve two grains or one- 
third of a dose of Tartar Emetic, (No. 1,) in half a pint 
of water, and give a tablespoonful every two hours, or 
6 grains of Fever Powder, (No. 45,) to relieve fever and 
produce sweat. Cloths dipped in cold water or vinegar 
should be applied to the head, a blister to the nape of 
the neck, and mustard plasters to the feet. If the liver 
or the lungs, or any other organs, should be particu- 
larly attacked, let a blister be applied over the parts* 
The patient should be kept as cool and quiet in body 
and mind as possible, and take the lightest diet. The 
bowels should be opened every day, and the course di- 
rected above continued until a crisis takes place. 

TYPHUS, or SLOW NERVOUS FEVER. 

A species of continued fever characterized by great 
debility, a tendency of the fluids to putrefaction, and 
the ordinary symptoms of fever. It is readily distin- 
guished from the inflammatory by the smallness of the 
pulse, and by the sudden and great debility which en- 
sues on the first attack. 

The most general cause is supposed to be contagion, 
but it may be occasioned by the effluvia arising either 
from animal or vegetable substances in a decayed or 
putrid state. A want of proper cleanliness, and con- 



46 

fined air, are likewise causes of this fever; hence it 
prevails in hospitals, jails, camps, and on board of 
ships, especially when such places are much crowded, 
and the strictest attention is not paid to free circulation 
of air, and due cleanliness. 

Symptoms. — On the first coming on of the disease^ 
the patient is seized with languor, dejection of spirits, 
great depression and loss of strength, universal weari- 
ness and soreness, pains in the head and hack and ex- 
tremities, and chills. The eyes appear full, heavy, yel- 
lowish, and often a little inflamed : the temples throb 
violently ; the tongue is dry and parched ; the breathing 
commonly laborious, with deep sighing ; the breath is 
hot and offensive ; the urine pale, the bowels costive, 
and the pulse is usually quick and small, and hard, and 
now and then fluttering and unequal. Sometimes a 
great heat, load and pain is felt at the pit of the sto- 
mach, and vomiting of bilious matter ensues. The 
pulse in progress of the disease increases in frequency 
from 100 to 130; there is a great debility, great heat 
and dryness of the skin, oppression of the breast, with 
anxiety, sighing and moaning ; the thirst is greatly in- 
creased, the tongue, mouth, lips and teeth are covered 
over with a brown or black fur, the speech is inarticu- 
late and scarcely intelligible, the patient mutters much, 
and delirium ensues. Other dangerous symptoms, not 
necessary to mention, here come on, until death closes 
the scene. Every case does not present all these 
symptoms, nor all so violent, as here described. Some 
cases are of a very mild character. 

Treatment. — In the very early stage of typhus 
fever, it may possibly be cut short at once, but where it 
has become seated, our remedies must be directed to 
palliate its violence until its course is run. To this end 
if there is much fever, give an Emetic, (No. 41,) as di- 
rected under that head, until vomiting occurs. If the 
patient is feeble, give an Emetic of Ipecac, (No. 47,) in 
the dose of thirty or forty grains taken at one draught 
Within an hour give ten grains of Calomel, (No. 3,) 
followed in four or five hours with a dose of Salts, 
(No. 8,) in cold water or a tablespoonful of Cream of 



47 

Tartar, (No, 10 :) let the " anti-febrile regimen," for an 
account of which see "General Rules," page 35, be 
adopted through the course of this and every other 
fever. When the skin is uniformly very hot and dry, 
cold water should he either dashed upon the whole 
body or applied with a sponge over the whole surface. 
Let the patient be kept as quiet as possible, both in 
mind and body. His diet should be barley water or 
other mild liquid, thin arrow-root or Indian gruel. 
Cream of Tartar dissolved in water and sweetened a 
little, or lemonade, may be freely used. Twenty grains 
of Nitre, (No. 50,) or a teaspoon even full may be di- 
vided into two doses, each dose may be dissolved in a 
wine-glass of cold water and drank immediately, and 
repeated every two or three hours. Let the clothing be 
light. A Dover's Powder, (No. 46,) may be adminis- 
tered at night to procure sleep and promote perspiration. 
Spirits of Nitre, (No. 20,) may be given every three 
hours, a teaspoonful in a little toast water or cold 
water. The bowels should be kept open daily by a 
moderate dose of salts or rhubarb, or by injections. 

If under these means the system appears to be sink- 
ing, a more nutritious diet must be used with a moder- 
ate quantity of wine, Peruvian Bark, (No. 11,) or Qui- 
nine, (No. 48.) Not over half a pint of wine in a day 
need be taken, and may be given in the form of san- 
garee. A wine-glass of the decoction of bark (see 
Recipes,) once in three or four hours, according to the 
urgency of the case, 10 or 15 drops of Elixir Vitriol, 
(No. 14,) may be added to the decoction. The patient 
may use freely the juice of ripe fruits of tropical cli- 
mates, roasted apples, &c. If white specks or small 
sores in the mouth appear, a gargle may be made by 
adding about a teaspoonful of elixir vitriol to a tumbler 
of water sweetened, which may be applied by a small 
swab to the mouth and back parts of the throat. 

If the disease inclines more to the nervous form, 
with much anxiety of mind, tremors and spasmodic 
twitching of the muscles, give one teaspoonful of Ether, 
(No. 21.) and Dover's powder, (No. 46,) in the dose 
from 10 to 20 grains once in 6 or 8 hours. The ether 



48 

may be repeated every two or three hours. Half a tea- 
spoonful Spirits Camphor, (No. 26,) and twenty drops 
of Spirits Hartshorn, (No. 17,) may be added to the 
ether. It will be found useful, also, sometimes to 
apply warm water in bottles to the feet, and mustard 
plasters upon the inside of the ankles and wrists. It 
will be always right to shave the head, and keep it 
cool by cold water or spirits and water, and to apply a 
blister to the back of the neck. If a diarrhoea comes 
on, give Dover's Powder, or small doses of Ipecac, 
[see Ipecac*,] (No. 47.) In profuse sweats, administer 
decoction of bark and elixir vitriol, or the mixture o/ 
ether, hartshorn and camphor, mentioned above, every 
hour. 

The decoction of bark and elixir vitriol may be used 
as the patient recovers, three times a day, to restore 
strength, intermitted sometimes for Bark Bitters, (No. 
25.) Care should be taken when the patient is recover- 
ing, that by no exposure to weather, excess in diet or 
exertion, a relapse is brought on. Boneset or chamo- 
mile tea may be given at any period of the disease, and 
are useful both in preserving the strength of the system, 
and the organs of digestion. 

Clean clothes and washing the body with cold water 
are very important means of cure. The free use of 
cold water is to be allowed in all fevers. 

SCARLET FEVER. 

Symptoms. — This disease commences with the usual 
symptoms of fevers, and may be distinguished from 
measles, which it sometimes resembles, by the absence 
of cough, watery eye, running at the nose, and sneezing. 
The thirst is considerable, the skin dry, and the disease 
attended with nausea and vomiting. It commences 
sometimes with vomiting. About the third day the 
scarlet efflorescence or eruption appears, which is 
usually out only three or four days, and covers the 
body with one universal redness. 

Treatment. — Commence with a dose of Tartar 
Emetic, (No. 1,) followed by a dose of Epsom Salts, 
(No. 8). 



49 

Sponge the whole body when hot with cold water, 
and repeat the sponging as often as the heat rises. 
Where the heat is excessive, take the patient out of 
bed, and dash on a bucket of fresh or sea water. Let 
an Antimonial Fever Powder, (No. 45,) be given every 
three hours, or the solution of tartar emetic every two 
hours, a tabiespoonful as mentioned under the head of 
pleurisy. Should the throat be much inflamed and 
swelled, leeches, if they can be procured, must be ap- 
plied, 2 or 3 to each side of the throat. Volatile Lini- 
ment, made by mixing equal parts of Hartshorn, (No. 
17,) and Sweet or Castor Oil, (No. 12,) should be rub- 
bed upon the neck several times a day. The inside of 
the throat may be swabbed frequently with water, made 
pretty sour with Elixir of Vitriol, (No. 14.) Should 
the disease exhibit a typhus or sinking character, with 
ulcers in the throat of a dark color, it will be necessary 
to support the system with nutritious diet, with a mode- 
rate quantity of wine, decoction of bark, (see Recipes,) 
or Quinine, every two hours, with ten or fifteen drops of 
elixir vitriol. The bowels should be opened daily. 

SMALL POX. 

Is of two kinds, the distinct and the confluent. The 
eruptions in the first are separate ; in the latter they run 
into one another. 

Symptoms. — The first form commences with redness 
of the eyes, soreness of the throat, pains in the head, 
back and loins, weariness and faintness, chilliness, 
heat, thirst, sickness of the stomach, and a quick pulse. 
There is also a peculiar feeling of distress at the pit of 
the stomach. Children are often attacked with a fit, 
and I have seen one case myself of an adult who was 
attacked thus. 

About the third or fourth day from the first attack, 
the eruption begins in little red spots on the face, neck 
and breast, and these continue to increase in number 
and size for three or four days, when they will be dis- 
persed over several parts of the body. About the fifth 
or sixth day the matter begins to form, at which time a 
small vesicle, containing an almost colorless fluid, may 
5 



50 

be observed on the top of each pimple. About the 
eighth or ninth day the vesicle will be filled with a 
thick yellow matter. Other symptoms which need not 
be enumerated here succeed in the course of the dis- 
ease. 

Treatment. — If the patient is a person of good con- 
stitution and full habit of body, from 12 ounces to a 
pint of blood may be taken from the arm. An Emetic, 
(No. 1,) if there is no particular tenderness of the 
stomach, should be given. The feet may be bathed in 
warm water, and two large spoonfuls of Salts, (No. 8,) 
should be given, followed every three hours with a 
Fever Powder, (No. 45.) This course will have a ten- 
dency to prevent swelling and pock upon the face- 
The foot bath may be repeated if there is much affec- 
tion of the head and face at any time, and mustard 
plasters applied to the feet unless they are dropsical. 
The body should be kept cool ; the drinks may be cold 
lemonade or a solution of Cream of Tartar, (No. 10,) 
slightly sweetened; the bowels should be kept open 
daily by one or two teaspoonfuls of Sulphur, (No. 9.) 
Small quantities of Nitre, (No. 50,) may be dissolved 
in a tablespoonful of cold water, and taken immediately 
once in three hours. To relieve the throat, a gargle, 
made by rendering water pretty tart with Elixir Vitriol, 
(No. 14,) will be proper, and also the breathing of the 
vapor of warm water or vinegar. The pustules, when 
filled, should be opened with a sharp pointed instrument, 
over the whole body, and the matter sponged away 
with warm water. It may be necessary to repeat this 
operation when the pock fill again. 

Should the small pox occur in a family, or on board 
ship, the persons exposed should prepare their systems 
for a mild attack, by cooling purges and a light diet. 

The diet of the patient should be of the lightest 
kind, and all the means of lessening fever should be 
tried. When the pustules begin to scab, the patient 
may be pretty freely purged. 

Sometimes the pulse sinks, the pock do not rise or 
are filled with a thin watery or bloody fluid, the skin 
becomes purple j Then make free use of wine, decoc- 



51 

tion of bark, combined with 10 or 15 drops of Elixir 
Vitriol, (No. 14.) A teaspoonful of Ether, (No. 21,) 
may be added to the wine once in two hours, until the 
system rallies. A teaspoonful of Spirits of Camphor, 
(No. 26,) may be administered with 12 drops of Harts- 
horn, (No. 17,) every three hours in half a wine-glass 
of water. The scabs may be kept soft with Sweet Oil 
or with the Cerate, (No. 29.) If blood flows from the 
gums, bowels, or the stomach, use a weak solution of 
Alum, (No. 43.) The same maybe applied lo the eyes 
to prevent loss of sight. In the second or confluent 
form, the stomach and bowels should be evacuated, and 
means used to moderate the fever as in the other form. 
Ipecac, (No. 47,) is a more suitable emetic than the 
Tartar Emetic, (No. 1,) and where the system seems to 
sink it must be supported by the decoction of bark and 
the elixir of vitriol every four or six hours, and a 
Dover's Powder, (No. 46,) every eight hours. When 
alarming convulsions occur, 40 to 60 drops of Lauda- 
num, (No. 16,) must be given. If there is diarrhoea, it 
must not be wholly stopped. If the pustules should 
flatten, proceed <&s mentioned above, and other symptoms 
mentioned under the first variety should be treated as 
there directed. 

MEASLES. 

Symptoms. — Are known by hot fever, hoarseness, 
dry cough, sneezings, drowsiness, watery eyes, and 
redness of the eyes. About the fourth day there is an 
eruption of small red points, discernible by the touch, 
which after three days go off, commencing at the head 
and going towards the extremities. 

Treatment. — Let the patient's bowels be moved by 
Epsom Salts, (No. 8,) or some other mild physic. 
Should there exist no threatening symptoms, the patient 
needs but little more than to avoid both heat and cold, 
drink freely of tea of Flaxseed, (No. 37,) and to keep 
his bowels open. 

Should the patient be of a robust habit, and full of 
blood, with considerable affection of the breathing, 
from three gills to a pint of blood may be taken from 



52 

the arm. An emetic of Ipecac, (No. 47,) combined 
with two grains, or one-third of a dose of Tartar 
Emetic, (No. 1,) will often relieve this symptom, and 
throw the measles out upon the skin. Should there be 
pains in the chest, bleeding must be resorted to, and 
the treatment mentioned in pleurisy follow. The solu- 
tion of tartar emetic mentioned above, with the flax- 
seed tea, should be given every two hours, unless the 
disease is of a sinking character, when the tartar 
emetic should be omitted. A blister may be applied as 
directed in pleurisy, after bleeding, if pain in the chest 
continues. Care should be observed, as the measles go 
off, to avoid exposure to cold, as the lungs are left in 
an irritable state. Should the eruption leave the sur- 
face, the warm bath should be administered, and other 
gentle means to promote perspiration. A gentle emetic 
of ipecac, will sometimes alone effect this. 

ERYSIPELAS, or ST. ANTHONY'S FIRE. 

Symptoms. — Fever, delirium, vomiting, pulse strong 
or weak as the fever inclines to the inflammatory or 
typhus kind, — on the fourth day, sometimes on the 
second or third, the skin in some one part becomes red 
and inflamed, which is soon extended to others, — the 
parts affected being swollen and of a bright scarlet. If 
the face is attacked, it spreads itself on the scalp, and 
the eyelids sometimes swell so as to prevent the patient 
from seeing, — after a longer or shorter period, the erup- 
tion ends in small watery vesicles, or blisters, or in 
branny scales. At this period, the fever sometimes 
abates, at others, drowsiness or delirium comes on, 
which increases it, and destroys the patient by the 
eleventh day. 

Causes. — Cold, excessive heat, intemperance, acrid 
bile, or other irritating matter in the stomach and in- 
testines. 

Treatment. — On its first appearance give an emetic 
of Ipecac, (No. 47,) and after its operation, six or 
eight grains of Calomel, (No. 3,) followed in about two 
hours by a dose of Epsom Salts, (No. 8,) until the 
bowels are well emptied. The surface affected may be 



53 

covered with scorched flour. A narrow blister, cover- 
ing partly the sound and partly the diseased surface, 
wherever the plaster can be applied, will ordinarily 
check the extension of the disease. If erysipelas at- 
tacks the limbs, the blister should surround the part 
affected. Lunar caustic if it can be procured, should 
be moistened, and drawn over the sound and diseased 
surface about an inch in width. Diluting drinks, such 
as lemonade or a solution of cream of tartar, barley* 
water, &c, should be given. Stimulating food and 
drink must be avoided. 

If the disease continues to increase after the bowels 
are moved, give a teaspoonl'ul of powdered bark (No. 
11,) once in an hour until the inflammation is lessened, 
or if you have not the powdered bark, a grain of qui* 
nine, (No. 48.) 

Erpsipelas sometimes attacks a wound, which imme* 
diately puts on a very alarming appearance. The sore 
spreads, the surrounding skin becomes hot, painful and 
red, and the patient becomes feverish. A fermenting 
poultice, mide by pouring yeast upon an ordinary poul- 
tice, spieal thick, should be applied to the wound. To 
prevent the erysipelas from spreading, the blister or 
lunar caustic should be employed as before directed. 
As the bad state of the wound proceeds from constitu- 
tional disturbances, the state of the constitution should 
be attended to. 

During* the first attack of the disease, the bowels 
must be kept free, the diet should be low, and if the 
pain be great, give a teaspoonful of Spirits of Nitre, 
(No. 20.) and ten drops of Laudanum, (No. 16,) in a 
tablespoonful of water, and repeat the dose in three 
hours if necessary. As soon as the matter begins to 
escape, or should there be the least appearance of mor- 
tification, which will be known by the dark color of the 
part and the bad smell, the whole treatment should be 
changed. The diet should be of the most nourishing 
kind and a free allowance of wine and porter per- 
mitted. A grain of opium, or twenty drops of lauda- 
num, if solid opium is not to be procured, must be 
given every two hours, and also a teaspoonful of Pe- 
5* 



54 

ruvian bark, (No. 11,) or a grain of Quinine. Matter 
should not be allowed to burrow, but be discharged by 
Yery free openings. The bandages should be carefully 
changed twice a day. The patient should be kept quiet, 
free from company, and his bed cool and dark. 

The following is from a Medical Journal published 
in England, and is worthy of a place here : — u M. Vel- 
peau declares that, having frequently failed with the 
usual remedies employed against this malady, a new 
idea suggested itself to him from a consideration of 
the modifications produced upon the blood by the pre- 
parations of iron. He was thence led to employ as a 
local application, a solution of the Sulphate of Iron 
(copperas), in the proportion of one ounce to a pint of 
water, or an ointment containing two drachms to an 
ounce of lard. The ointment he considers a more con- 
venient application for the head, neck and trunk. 
Great care is requisite, however, in thoroughly powder- 
ing the copperas, before mixing it with the lard. It 
should then be rubbed freely over the whole inflamed 
surface and even a little beyond. The solution is to 
be employed by folded linen or muslin, moistened every 
six hours and maintained on the part by means of a 
bandage. 

The skin must be kept constantly moist. One of 
the inconveniences of the copperas is that of reddening 
the linen with which it comes in contact. Velpeau 
states that in twenty-four cases, in which he'employed 
this application, the most marked and rapid influence 
was exerted over the eruption. In no instance did the 
same spot of inflammation resist this means more than 
twenty- four or forty-eight hours. 

NETTLE-RASH. 

This disease is sometimes called the hives, and also 
improperly erysipelas. It attacks with some fever, and 
is followed by an eruption of white or red blotches, 
resembling the stinging of nettles. The blotches usu- 
ally come out suddenly, especially if the skin be rub- 
bed or scratched, and are attended with itching and 
burning. They seldom stay many hours in the same 



55 

place, sometimes not many moments. No part of the 
body is exempt from them. Where many of them rise 
together and continue an hour or two, the parts are 
often considerably swelled, especially the arms, face 
and hands. These eruptions will continue to infest 
the skin sometimes in one place and sometimes in an- 
other for one or two hours together. This may occur 
several times a day. In some constitutions this disease 
lasts only a few days, in others months. 

Causes. — Some particular kinds of food, as lobsters 
and other shellfish, a disordered state of the digestive 
organs. It is not always that we can assign a cause 
for the disease. 

Treatment. — Any cooling purge will be found use- 
ful, as salts, (No. 8,) cream of tartar, (No. 10,) two 
tablespoonsful of either in a half tumbler of water. 
Should this not carry off the eruption, give a blue pill, 
{No. 7,) at night and a dose of rhubarb and magnesia 
in the morning. This may be repeated two days after- 
ward. A warm bath in connection with the medicines 
is always an appropriate remedy. 

INFLAMMATION OF THE BRAIN. 

Symptoms. — Intense pain in the head, — the eyes in- 
capable of bearing the light, — delirium, — face flushed, 
—oppression at the breast, — the pulse hard, and very 
rapid, — tongue, at first of a fiery red, then yellow, 
brown, or black. 

Causes. — Exposure to excessive heat of the sun, — 
blows on the head, — intense application to study, — in- 
temperance. 

Distinguish it from inflammatory fever by the pulse, 
which in the one is full, strong and regular ; in the 
other, hard, quick and corded ; and by the raving de- 
lirium. From typhus by the two latter marks. 

Treatment. — Bleed the patient as quickly as pos- 
sible, until he nearly faints. Upon the resolute em- 
ployment of the lancet in the onset, we must place 
our chief dependence. The bowels should be freely 
opened with Epsom Salts, (No. 8,) the head shaved, 
and a blister, or cloths dipped in iced vinegar and 



56 

water, or pounded ice, be applied to it, the feet bathed 
at the same time in warm water, and the room kept 
perfectly cool, dark and quiet, and no company should 
be admitted. Rice water, lemonade, or cold water, is 
to be the only diet. Should the violence of the disease 
not give way to these remedies, repeat the bleeding, 
blistering, &c, as often as may be necessary. The 
most vigorous measures to reduce the inflammation are 
required, or death will be the consequence. 

QUINSY, OR INFLAMMATORY SORE THROAT. 

Symptoms. — Difficulty of swallowing and breathing, 
accompanied by redness and swelling of one or both 
the tonsils or almonds of the ears, as they are some- 
times called, dryness of the throat, foulness of the 
tongue, sharp pains in the parts, and some fever. As 
the disease advances, the swallowing and breathing 
become more difficult, the speech is very indistinct, the 
dryness of the throat and thirst increases, the tongue 
swells and is covered with a dark fur, the pulse is full 
and frequent. 

Treatment. — Give an emetic, (No. 1,) followed by 
a dose of Epsom Salts, (No. 8.) Rub the neck well 
several times a day, with Opodeldoc, (No. 23,) mixed 
equally with Hartshorn, (No. 17.) Let the patient 
drink freely of weak tea of Boneset, (No. 49,) to pro- 
mote perspiration. If the swelling increases, draw in 
the vapor of warm water through the muzzle of a tea- 
pot; care is to be taken not to scald the patient's 
throat and lungs by having the water too hot. Gargle 
the throat with a weak solution of alum, (No. 43.) 
Sometimes the swelling produces a complete stoppage 
of the throat even to suffocation. The vapor of Ether, 
(No. 21,) should be inhaled, or the swelled gland 
opened with a lancet. 

PLEURISY. 

Symptoms. — This disease comes on with a sharp 
pain in the side which is increased by a long breath, 
it is attended with flushing of the face, increase of heat, 
strong chills, difficulty of lying on the side affected, 



57 

hard dry cough at the first, sickness of the stomach, the 
pulse strong and frequent, and feels under the finge* 
like the stretched string of a violin. 

Treatment. — Bleed the patient from a large orifice, 
until he can take a long hreath with little or no pain. 
If the blood after standing a little time has a yellow 
crust upon the surface, or becomes cup shaped, it will 
be necessary probably to take blood again. Let two 
grains, or one-third of an Emetic Powder, (No. 1,) be 
dissolved in a tumbler of water, and give the patient a 
tablespoonful every hour to relieve cough and fever, 
and let him drink freely of flaxseed tea. A dose of 
salts should be administered immediately after bleeding. 
A blister should also be applied over the seat of the 
pain. Should the pain continue, and the pulse be hard, 
more blood should be taken, and in general, so long as 
the yellow coat appears upon the blood, bleeding is ne- 
cessary. As the symptoms subside a Dover's Powder, 
(No. 46,) at night, will be useful. Let the diet be toast 
water and gruel, as long as the fever continues, or the 
pulse is hard. Should cough remain, use the cough 
drops. [See Recipes, p. 30.] 

INFLAMMATION OF THE LIVER, 

OR LIVER COMPLAINT. 

Symptoms. — This disease appears in two forms, the 
acute and the chronic. The acute comes on with sharp 
pain under the short ribs, extending up to the collar- 
bone and shoulder, which is increased by pressing the 
parts on the right side over the liver, and is accom- 
panied by cough, oppression of breathing, difficulty of 
lying on the left side ; the urine is of a deep saffron 
color, and small in quantity ; great thirst, costiveness, 
with strong, hard and frequent pulse ; and after a few 
days the skin and eyes become of a deep yellow. 

Treatment.— If the symptoms are severe, and the 
constitution good, a full bleeding will be necessary ; 15 
or 20 grains of Calomel, (No. 3.) should be administer- 
ed, followed by two tablespoonsful of Salts, (No. 8.) 
A large blister should be applied to the right side, over 
the pain. If the bowels should not be freely opened, 



58 

give a dose of Calomel and Jalap, (No. 2.) Two Mer- 
curial Pills, (No. 7,) should be taken at night, and one 
in the morning, until the mouth is a little sore. Give a 
Dover's Powder, (No. 46,) night and morning. 

The chronic species is usually accompanied with a 
callow complexion, loss of appetite and flesh, costive- 
ness, indigestion, flatulence, pains in the stomach, a 
yellow tinge of the eyes, clay-colored stools, high-color* 
ed urine, depositing a red sediment and ropy mucus : a 
dull pain in the region of the liver, extending to the 
shoulder, and sometimes with considerable asthma. 
Give calomel and jalap and the mercurial pills as di- 
rected above. A blister should occasionally be applied 
to relieve pain. Keep the bowels open by Rhubarb, 
(No. 4 ;) keep up the strength by nutritious diet, and 
give a teaspoonful of the Bitters, (No. 25,) three times 
a day in water. 

If an abscess, or swelling containing matter, points 
outwardly, apply bread or flaxseed poultices to the 
swelling, omit the mercurial pills, and use wine, infusion 
of bark (see Recipes,) freely, and a generous diet. As 
soon as matter is felt within it, open it at its lowest and 
most projecting part with the point of a lancet, and let 
out its contents very slowly, taking care not to close the 
wound until this is completely effected. 

JAUNDICE. 

Symptoms. — Languor, loathing of food, a bitter taste 
in the mouth, vomiting, the skin and eyes of a yellow 
color, the stools clayed, and the urine giving a yellow 
tinge to rags dipped in it. There is a dull pain in the 
right side under the last rib, which is increased by 
pressure. When the pain is severe there is fever, the 
pulse is hard and full. 

Treatment. In general 6 or 8 grains of Calomel, 
(No. 3,) should be administered at night, followed 
next morning by 15 grains more, or by a dose of Calo- 
mel and Jalap, (No. 3.) This course may be repeated 
the second night after. Should the disease not give 
way, give one of the blue pills, (No. 7,) every night. 
or rather half a pill night and morning. 



59 

Sometimes, an Emetic, (No. 1,) will be found neces- 
sary to rouse the bilious system in the first stage and 
afterwards. Spirituous liquors are at all times to be 
abstained from, but especially in this disease. 

INFLAMMATION OF THE BOWELS, 

Comes on with sharp pains over the whole belly, but 
more especially around the navel, accompanied with 
belchings, sickness of the stomach, vomiting of bili- 
ous matter, obstinate costiveness, thirst, heat, great 
anxiety, and a quick, hard, and small pulse. After a 
short time the pain becomes more severe, the bowels 
seem drawn together by a kind of cramp, every part 
of the belly is very painful to the touch, and seems 
drawn into lumps ; great costiveness prevails, and the 
urine is passed with great difficulty and pain. The 
inflammation continuing to proceed with violence, 
ends in mortification ; or, abating gradually, the patient 
recovers. Mortification has taken place when the 
pain ceases suddenly, with sinking of the pulse, 
shrinking of the features, and swelling of the belly. 

Inflammation of the bowels should be distinguished 
fromcholic: in the former, the pain is increased by" 
pressure upon the belly, while in cholic it is relieved 
by it. 

Treatment. — Bleed as freely as the strength of the 
patient will allow. Put the patient in a hot bath if 
possible, or if that cannot be done, apply hot fomenta- 
tions to the belly. If leeches can be procured, two 
dozen may be applied over the belly, and a large blister 
be applied over the whole. It is very important to 
cleanse the bowels by a large laxative glyster, (see 
Recipes,) repeated until the bowels move freely. An 
ounce of Castor Oil, (No. 12,) may be given every hour 
until it operates, or a tablespoonful of Epsom Salts, 
(No. 8,) in the same way. If this disease has been 
preceded by costiveness, 15 or 20 grains of Calomel, 
(No. 3,) will be necessary. The diet should be of the 
lightest kind — the bowels should be kept open by gentle 



60 

means — avoid exposure to cold, or anything else likely 
to bring on a relapse. 

^@* Remember that this complaint frequently runs its 
course in a day or two, and that unless the lancet be fear* 
lessly employed in the very beginning, mortification and 
death ensue. If a strangulated rupture occasion the dis- 
ease, the same, and if possible, still stronger reasons 
exist for bleeding, previous to any attempt to replace 
it. 

RHEUMATISM. 

Symptoms.— The acute form attacks with the ordi- 
nary symptoms of fever, which are soon followed by- 
excruciating pains in different parts of the body, parti- 
cularly in the large joints, shifting from one part to 
another, leaving a redness and swelling in every part 
they have occupied, as likewise great tenderness to the 
touch. Towards evening there is an increase of fever, 
and during the night the pains are more severe. 

Treatment. — Bleed the patient freely, give him fif- 
teen grains of Calomel, (No. 3,) followed in three hours 
by a tablespoonful of Sulphur, (No. 9,) and a Dover's 
Powder, (No. 46,) in molasses, with one of the Antimo- 
nial Powders, (No. 45,) after the bowels have been 
opened. If relief is not obtained, bleed again, and re- 
peat the remedies. The feet may be bathed in warm 
water, and the Dover's Powder repeated every six 
hours, the antimonial powder every three hours, or two 
grains of tartar emetic, or one-third of one of the 
Papers, (No. 1,) may be dissolved in half a pint of 
water, of which one or two tablespoonsful may be 
taken every two hours through the course of the dis- 
ease. When the fever is removed, and nothing remains 
but the pain and swelling, rub the parts well with 
Opodeldoc, (No. 23,) and take a teaspoon even full of 
sulphur three times a day. The most satisfactory re- 
medy for rheumatism that I have ever used is the hy- 
driodate of potash, one drachm dissolved in a pint of 
water, dose, half a wine glass three or four times a day. 
It may be increased to twice that quantity. A well 



61 

made decoction or syrup of Sarsaparilla may be com- 
bined with it to render it more effectual. 

VOMITING, 

Arises from various causes ; sometimes from a dis-* 
ordered or overloaded stomach, improper diet, &c. 
Vomiting is often a symptom of some particular dis- 
ease. When it comes on without fever or other dis- 
turbances, the treatment mentioned in cholera morbus is 
appropriate. If the matter thrown up is acid, a tea- 
spoonful of saleratus, magnesia, or supercarbonate of 
soda in half a tumbler of cold water will frequently 
check vomiting at once. Ten or fifteen grains of calo- 
mel, (No. 3,) taken in a pill or a very small quantity of 
molasses, often quiets the stomach instantly. Apply 
a plaster of mustard or black pepper to the pit of the 
"stomach, or if neither are at hand, wring out cloths in 
hot water and lay them to the stomach. Sometimes 
the most speedy remedy is an emetic of Ipecac. , 
(No. 47.) 

DIARRHCEA, or LOOSENESS. 

Symptoms. — Frequent and copious evacuations by 
stool r generally with griping. Frequently there is 
sickness of the stomach, thirst, bitterness, and dryness 
of the mouth. 

Treatment. — It is not safe, generally, to check the 
looseness with laudanum or binding articles, before the 
stomach and bowels have been emptied, but in that 
looseness which precedes Asiatic Cholera, it must be 
used immediately, in connection with the prescription 
of Rhubarb, &c, in the article upon Cholera Morbus, 
One of the best remedies is Ipecac, (No. 47,) given as 
directed under that head. Thirty grains, or a teaspoon- 
ful of Rhubarb, and two or three teaspoonsful of Mag- 
nesia, (No. 5,) with 30 or 40 drops of Essence of Pep- 
permint, .(No. 18,) and half a tumbler of water, should 
follow the ipecac, within one or two hours, or it may 
be given without using ipecac, at all. Let the patient 
drink freely of flaxseed tea, or barley water. When 
the bowels have been evacuated, give fifteen grains of 
6 



62 

Dover's Powder, (No. 46,) or 25 or 30 drops of Lauda- 
num, (No. 16.) If the stools are white or clay-colored, 
add ten grains of Calomel, (No. 3,) to the Rhubarb in- 
stead of magnesia. At any time after the bowels have 
been moved by the above, give the tonic solution of 
zinc and alum, (see Recipes,) a teaspoonful every three 
or four hours. If there is no fever, a Dover's Powder 
may be given every six or eight hours. The tonic so- 
lution may be continued three times a day to prevent a 
relapse, and to give strength and appetite. Should the 
disease seem to arise from acidity of the stomach, a 
teaspoonful of saleratus or super-carbonate of soda, dis- 
solved in a tumbler of water, and used freely, will be 
found serviceable. Should the stools continue light or 
clay-colored, a Blue Pill, (No. 7,) should be taken at 
night, for three or four days. Perspiration excited by 
gentle means is very serviceable in this disease, as well • 
as in dysentery. The diet of the patient should be 
carefully attended to, and consist of such articles as 
arrow root, sago, rice, &c. 

The chalk mixture mentioned in a previous chapter 
is an excellent remedy in almost every case, especially 
after the bowels have been moved by cathartics and 
fever has subsided. 

In that form of diarrhoea with which the late emi- 
grants from Europe have been afflicted, a ship-master 
directed a tablespoonful of wheat flour stirred up with 
cold water to be administered and repeated two hours 
afterward. This treatment was successful in more than 
fifty cases. 

DYSENTERY, 

Symptoms. — Severe griping, often preceded by loss 
of appetite, sickness of the stomach, costiveness and 
chills — frequent inclinations to go to stool, heat and 
irritation of the fundament. The stools are sometimes 
slimy, sometimes bloody. Hardened lumps sometimes 
pass with the slime, when temporary relief ''follows. 
Some patients discharge a film of hardened mucus, like 
the scrapings of the intestines. Violent straining at 
stool, the patient feels a bearing down as if the bowel* 



63 

were falling out; sometimes the gut does protrude. 
Great debility soon ensues with a quick and weak 
pulse. 

Treatment. — Give Ipecac., (No. 47,) thirty grains, 
calomel, 15 grains, or the contents of one of the pa- 
pers, (No. 3,) in molasses. If the pains are violent, 
give two grains of opium, or 40 to 50 drops of Lauda- 
num, (No. 16,) mixed with ipecac, and calomel. Drink 
freely of barley water, flour gruel, or of Arrow Root, 
(No. 38,) or of tea of Flaxseed, (No. 37.) Where great 
pain and inflammation exist after the stomach is clear- 
ed, a blister may be applied to the belly, or flannel 
cloths wrung out in hot water, and laid as hot as can 
be borne upon the belly, repeated as they cool, and 15 
or 20 drops of laudanum given every hour in the pa- 
tient's drink, until relief is procured. 

Bleeding, in severe cases and vigorous constitutions, 
may be employed, but should not be generally resorted 
to. When great pain exists in the lower part of the 
belly, with frequent stools, administer injections of 
thin flour starch, or flaxseed tea, one gill, laudanum, 
a teaspoonful, blood-warm, which should be kept up 
as long as possible, and repeated as often as dis- 
charged. Twenty or thirty grains of calomel admi- 
nistered in such cases both relieve the pain and check 
the discharges, when smaller doses would have but 
little effect. 

The chalk mixture described under the head of 
41 Recipes" has long been a favorite remedy with phy- 
sicians. 

No solid food should be eaten ; but toast-water or 
arrow-root may be taken freely. The soft part of a 
roasted apple, or other ripe fruit, may be allowed. At 
an advanced stage, when the frequency of stools seems 
to be from a weak state of the bowels merely, the fol- 
lowing will be found excellent: — White Vitriol, (No. 
41,) three drachms, or a tablespoonful, not heaped, and 
Alum, (No. 43,) one drachm, or a piece as large as a 
middle sized chestnut, and a pint of boiling water. 
Dose, a teaspoonful every four hours, or dissolve in a 
tablespoonful of water, as much white vitriol as it will 



64 

Bear. To every teaspoonful, add five teaspoonsful of 
Laudanum, (No. 16,) and give to an adult 15 drops 
every four hours, increasing one drop daily. A dose 
of Castor Oil, (No. 12,) should precede it and be re- 
peated every other day. It will be proper, at any time, 
to produce sweat by gentle means, such as bathing the 
feet, &c. 

CHOLERA MORBUS. 

VOMITING AND PURGING. 

Symptoms. — A frequent discharge of bile by vomit- 
ing or purging, with pain and distention of the stom- 
ach, thirst, great anxiety, cramps in the legs, cold 
sweats, and sometimes death in less than twenty-four 
hours. 

Causes. — Exposure to excessive heat, sudden check- 
ing of perspiration. The disease most commonly oc- 
curs when hot days are succeeded by cool nights, in 
the latter part of July and August. It arises also from 
indigestible food, cucumbers, melons, poisons, stale 
provisions, shell-fish, especially lobsters. 

Treatment. — If vomiting has not already evacuated 
the stomach sufficiently, give one of the doses, or thirty 
grains of Ipecac, (No. 47,) as directed. Generally, 
however, vomiting and purging has come on before 
medicine is administered. The best remedy I have ever 
known is the following : — 

Rhubarb 60 grains, or two teaspoonsful. 

Super-carbonate of Soda or Saleratus, a tea- 
spoonful. 

Cayenne Pepper, an even teaspoonful. 

Strong Peppermint- water, half a pint. 

Or strong Mint Tea. 

Mix. Dose, a tablespoonful every half hour. 
A pill of opium as large as a small dry pea, if at 
hand, is better than laudanum, as it can be seen if 
vomited up , but if not, give from 40 to 60 drops of 
Laudanum, (No. 16,) with Essence of Peppermint, (No. 
18.) If the patient vomits it up, try it again. Apply 
a mustard or Cayenne pepper plaster to the pit of the 
stomach, and to the ankles or wrists, or flannels wrung 



65 

out in hot water to the stomach, and repeated as they 
cool. Drink freely of a solution of soda or saleratus in 
water. Sometimes 10 or 15 grains of calomel, either 
made into a pill with a very little molasses, or in pow- 
der, will remain upon the stomach when everything 
else is thrown up. 

ASIATIC CHOLERA. 

The limits of this work do not admit of any discus- 
sion of the various theories respecting the nature of 
this disease. It seems evident to me that the epidemic 
influence, whatever it may he, so acts upon the human 
body as to bring about a sort of hemorrhage or dis- 
charge of the watery portion of the blood. 

Symptoms.— The attack commences with more or less 
looseness of the bowels, in general unaccompanied with 
pain, and is therefore apt to be unnoticed, or rather dis- 
regarded. This looseness varies in its duration from a 
few hours to several days, until the bowels are emptied 
of their ordinary contents. Then follows a thin fluid 
resembling rice-water. These last discharges are com- 
monly of a violent character and frequent. Vomiting 
soon succeeds of a similar fluid, followed by cramps in 
the fingers, toes, legs, and arms, and sometimes appa- 
rently of every muscle of the body. Sometimes the 
cramps precede the vomiting. There is no bile in any 
of the discharges. The eyes sink in their sockets, lose 
their luster and expression, the nostrils are contracted, 
the hue of the face is first leaden, then livid, then of a 
dark deep bluish color. The skin looks soaked or par- 
boiled, the abdomen contracts, and seems drawn almost 
to the spine, as if there was nothing in it, and the sur- 
face of the body is cold. The pulse becomes frequent 
and small, and ultimately imperceptible. The breath- 
ing continues with effort, and the ribs heave. The cramps 
subside, the action of the heart seems to stop entirely, 
so that its beating cannot be perceived even when the 
ear is brought close to the chest, and the breath becomes 
cold. The patient becomes stupid, is tormented with 
thirst, and complains of burning heat of the skin, al- 
though to the touch of others a is icy cold. Death gen- 
6* 



66 

erally follows. This is cholera as observed by the au- 
thor in the epidemic of 1832 in the city of New York. 
In some countries, it is said that in many cases the pes- 
tilence prostrates without warning its victim. 

Treatment. — This disease must be cured in its first 
stage of diarrhma with the least possible delay, otherwise 
the patient will as it were bleed to death. The prescrip- 
tion in the previous chapter of rhubarb, soda, &c. may be 
modified by the addition of two teaspoonsful of lauda- 
num, and given as there directed until two or three 
doses are administered, or twenty-five drops may be ad- 
ded to the first tablespoonful and omitted in the remain- 
der. The patient should keep his body quiet in a hori- 
zontal posture. Should the looseness continue, let two 
teaspoonsful of laudanum be mixed with half a tum- 
bler of water and be thrown up the bowels by injection, 
or the anodyne injection may be administered as de- 
scribed on page 31. I have repeatedly found that a 
diarrhoea which resisted the ordinary treatment has been 
immediately checked by twenty grains of calomeL In 
this disease, however, its operation should be followed 
immediately by twenty-five drops of laudanum. The 
anodyne or laudanum injection should be repeated as 
often as the bowels move. In extreme cases the lauda- 
num may be increased to a tablespoonful. Should 
cramps and vomiting ensue, give immediately a large 
spoonful of the rhubarb and soda mixture mentioned 
above. If thrown up it may be repeated, or the follow- 
ing mixture given. 

Laudanum, (No. 16) 60 drops. } 

Hartshorn, ( " 17) 40 do. I Mix with two 

Peppermint, ( " 18) one teaspoonful. j large spoons 

Sulp. Ether, (" 21) one do. }-of water and 

Spts. Camphor, ( " 26) one do. J give immedi- 

Tinct. Cayenne Pepper, one do. | ately. 

Or Cayenne Pepper, 5 grains. J 

If the patient throws up these doses, repeat at once. 
In the epidemic of 1832 I was accustomed to follow 
this last prescription by thirty grains of calomel. In 
the only case I have had in the present epidemic, I 
adopted successfully the same treatment, yet if the dis- 
ease prevalent was of a less violent character, I should 



67 

pTefer to rely upon the above stimulant remedies. Let 
tke patient without delay receive a thorough friction 
over the whole surface of his body with cayenne pepper 
moistened with alcohol or common spirits, or mixed with 
oil, until tke skin is reddened by the irritation.. Mustard 
may be substituted if the pepper is not at hand. Mustard 
plasters may also be applied to the stomach and bowels 
and to the inside of the wrists and ancles. Bathing 
the feet and legs in warm water produces a happy ef~ 
feet. If the patient is thirsty he may swallow freely 
cold water, ice-water, and ice itself, to restore to the 
blood what it has lost in the watery discharges. After 
his thirst is somewhat abated, let him drink freely also 
of chicken or mutton tea. 

In the third stage in which from the loss of fluids the 
patient becomes blue, or is in what is called the u col- 
lapse," it is exceedingly difficult to determine upon a 
hopeful course of treatment The free use of ice and 
cold water internally, with the application of external 
heat by flannels wrung out in hot water, warm poul- 
tices, bags of hot sand placed beside the patient, and in 
some cases even the warm bath, seem to be indicated 
•at this stage. 

The last or congestive stage is that of reaction or 
fever. Here there is great danger that some important 
organ, especially the brain, will suffer. This is to be 
relieved by three or four leeches to each temple, cold 
applications to the head, at the same time bathing the 
lower extremities in warm water. Mustard poultices 
should be applied to the inside of the ankles and wrists, 
and cooling drinks administered. Should excitement 
run high, bleeding will be demanded. 

In the course of two or three days, supposing the 
case to recover, discharges from the bowels take place ; 
they are then hard, and entirely without bile, or else 
they consist of black bile alone. The patient may then 
take ten grains of calomel and follow it with a small 
dose of castor oil, but its excessive action should be 
immediately checked. 

Cautions and Preventives. — During the prevalence 
of this disease all persons should beware of excessive 



68 

exertion of body or mind. Every person in a commu- 
nity where the epidemic exists feels more or less of its 
influence, disturbing the digestive organs, rendering 
articles of diet ordinarily harmless unsafe, such as fresh 
iish, fresh pork, veal, beets, radishes, salads, cabbage. 
All acid fruits are to be used very sparingly. Fear 
and all depressing passions expose the subject to any 
prevalent epidemic, while cheerfulness is an excellent 
preventive. Avoid cold currents of air, and the sudden 
suppression of perspiration. Use no cathartic medi- 
cines, especially Epsom salts, without extreme neces- 
sity. After two evacuations stop the action of any 
cathartic by laudanum. This last caution should be 
regarded for at least ten or twelve days after a vessel 
leaves a port where cholera prevails. All excesses in 
diet or drink predispose to the disease. Do not pro 
crastinate the use of the most efficient remedies at the 
least addition to the usual number of stools a day. The 
uncomfortable feelings of the digestive organs I have 
always found to be speedily relieved by a few grain** 
of supercarbonate of soda in a little water. 

CHOLIC. 

Symptoms. — The most prominent and principal symp- 
tom is pain about the navel, violent shooting and twist- 
ing coming on in fits, during which the patient is dis- 
posed to bend down and press upon the bowels. Cos- 
tiveness, sickness of the stomach, vomitings, bitter taste 
in the mouth, attend the disease. The pain of cholic 
is somewhat relieved by pressure, thus it may be dis- 
tinguished from inflammation of the bowels,, for which 
it may be mistaken. The latter will not admit of the 
slightest pressure. 

Causes. — Cold applied to the surface of the body f 
especially to the feet and bowels; shell-fish, as clams r 
lobsters, and other food of difficult digestion ; too great 
a quantity of bile, costiveness, long continued wind in 
the stomach and bowels, certain metallic poisons, a& 
lead, copper, and newly painted sleeping rooms. 

Treatment. — Let one teaspoonful of Ether, (No, 
21,) 40 to 60 drops Laudanum, (No. 16,.) one teaspoon- 



m 

fill of Spirits -Camphor, (No. 26,) with a little sugar 
and water, be taken immediately. Solid opium is to be 
preferred if it can be obtained, for if it is thrown up it 
can be seen, but if laudanum is used it cannot be known 
whether it is rejected or not, and it will be unsafe to 
repeat the dose. Repeat the dose in half an hour if 
relief is not obtained. Apply hot fomentations to the 
bowels, As soon as the pain lulls, or vomiting ceases, 
give three of the purgative pills, (No. 6,) or a full dose 
of Castor Oil, (No. 12,) with a teaspoonful of Essence 
Peppermint, (No. 18.) If acid exists in the stomach, 
use freely a solution of soda or saleratus. If the symp- 
toms become violent or continue, it will probably be 
necessary to take a pint of blood tern the arm. Cha- 
momile tea and Boneset will be found useful in all 
stages of the complaint. If the cholic proceed from 
lead, use freely castor oil, and full doses of calomel. 
When the bowels are evacuated, give the tonic solu- 
tion (see Mecipes) three times a day, a teaspoonful in 
water. 

APOPLEXY. 

In this disease the patient falls suddenly, without 
-sense or motion, and lies in a sleep-like state. It is 
sometimes preceded by head-ache, giddiness, dimness 
of sight, loss of memory, faltering of the tongue in 
speaking, numbness in the limbs, nightmare, &c. The 
face appears flushed, swelled and puffed up, the veins 
of the head and neck are distended with blood, the eyes 
are fixed, the breathing laborious and attended with 
snoring. 

Treatment. — Bleed immediately from a large orifice 
to the extent of a quart, if the senses do not return, 
apply ice or cold water to the head, and warm water 
or mustard poultices to the wrists and feet. As soon 
as he can swallow give a dose of calomel and jalap, 
fifteen grains of each, or one of the Papers, (No. 2,) in 
molasses, or four or five of the Pills, (No. 6,) followed 
by two or three tablespoonsful of Epsom Salts, (No. 8.) 
A blister may also be applied to the nape of the neck. 
The head of the patient should be elevated, and all the 



70 

ligatures removed from the neck. The bowels should 
be opened by the injection, (see Recipes) if the patient 
cannot take medicine by the mouth, and afterwards 
kept open by medicine. He must be very spare in his 
diet, and take no stimulating liquors. 

STROKE OF THE SUN. 

This proceeds from exposure to the sun's rays, and 
exhibits the same symptoms as apoplexy, commencing 
with ringing in the ears, &c, and must be treated by 
large and repeated bleedings, and in every other respect 
as directed for apoplexy. 

EPILEPSY, or FITS AND FALLING SICKNESS, 

A liability to this disease utterly disqualifies a man 
for seafaring life, as he cannot venture aloft without 
the risk, amounting almost to a certainty, of falling a 
corpse upon deck, or he may be attacked while hold- 
ing a light among combustible matter and set fire to the 
ship. 

The attack is sudden * the patient falls down in con- 
vulsions with a peculiar scream ; the pulse is suspend- 
ed, or very irregular ; the mouth is closed and frothy ; 
the hands clenched ; the eyes open and distorted ; the 
face often becomes black and the tongue is thrust out. 
During the fit the limbs are strongly contracted, and 
the whole body twists and works convulsively, with 
such violence as to require three or four strong men to 
hold the sufferer. In a few minutes the fit abates but 
is shortly renewed. After three or four returns the 
patient sighs, and although continuing senseless, passes 
into a deep sleep ; on awakening he has no recollection 
of what has occurred, but feels heavy and stupid. 

The only thing to be attempted during a fit is to 
place the patient in a cool airy situation, with his head 
elevated, and to protect him from bruising himself ; cold 
water should be thrown in his face. Any tight clothes 
about the patient should be loosened. A piece of soft 
wood should be placed between the teeth, if possible, 
to prevent his biting his tongue. If the fit is severe, 



71 

blood may be drawn at the earliest moment that it can 
6afely be done. 

In some instances it is preceded by pain in the head, 
unquiet sleep, noise in the ears, and a sensation of cold 
commencing in one of the limbs and creeping upwards 
until it reaches the head, when the patient falls into a 
fit. When the sensation of cold is first felt a string or 
handkerchief should be put tight around the limb, and 
twisted with a small stick kept in the string for the 
purpose. The tight pressure need not be continued 
more than a minute, and this simple apparatus may be 
go applied as to 'cause no impediment to labor. Pa- 
tients have thus averted the fits for months, who with- 
out it were attacked three or four times a week. The 
author cured one case with the conium and iron pills 
mentioned in the chapter on Irritation of the Spine. 

DELIRIUM TREMENS, or HORRORS. 

A disease occurring in dissipated habits. 

Symptoms. — One peculiar characteristic symptom of 
this disease is a great dread of impending evil, as being 
pursued by some one for the purpose of murder, by 
evil spirits, by snakes, or other reptiles. Sometimes 
the hair on the body is imagined to be covered by 
snakes, which the patient is continually trying to beat 
off. 

Treatment. — If it is possible to administer an emetic, 
let the patient have a dose of 30 or 40 grains of Ipecac. 
(No. 47,) followed by a dose of Calomel and Jalap, (No. 
2) ; in case the first cannot be administered, or even if 
it can, give a teaspoonful of Ether, (No. 21,) and 40 
drops of laudanum, (No. 16,) in a little sugar and water, 
and repeat the Ether in fifteen to thirty minutes until 
the patient is quieted. If in one hour he does not sleep 
give 60 drops of laudanum. Half a grain of sulphate 
of Morphine is to be preferred to the laudanum. The 
patient must sleep or die. When the disease subsides 
give two teaspoonsful of Tinct. Bark, (No. 25,) in wa- 
ter three times a day. 



72 

NEURALGIC AFFECTION, OR IRRITATION OF 
THE SPINE. 

This disease is exceedingly common T particularly 
among females. Though not ordinarily a dangerous- 
disease, it is productive of a great deal of suffering. It 
has been greatly overlooked, and the symptoms ascribed 
to quite a variety of complaints, as the liver complaint,, 
pleuritic attacks, and in one instance to inflammation 
of the bowels. It is partly on this account that the 
author has been led to give the symptoms, and his own 
successful treatment, in this book. 

Symptoms. — These are exceedingly varied, but the 
following are the most prominent. Although the pa-' 
tient may look well in the face and have a clean tongue 
and a good appetite, he will complain of pain in the • 
side, most frequently in the left, increased by taking a 
long walk, palpitation of the heart, shortness of the 
breath, shooting pains in the chest, bowels and limbs; 
sometimes the pain or soreness will be confined to one 
spot. One patient complained of a constant pain in 
her left breast and supposed she had a cancer. Some- 
times there will be a numbness of some of the limbs, 
spasms or twitches in the arms. The author's first 
patient had long been afflicted with epileptic fits, but 
was perfectly cured. Some patients are affected with 
frequent vomitings when the affection is nearly opposite' 
the stomach ; almost all complain of a dull pain in the 
front ©f the head, some are affected only with severe 
and long- continued head-ache. With many there is an 
uncomfortable feeling of the throat, or difficulty in swal- 
lowing. Sometimes female patients have complained 
of great tenderness of the vagina. Most persons who 
are afflicted with excessive nervousness will be found 
laboring under irritation of the spine. 

Upon making pressure with the hand upon the back 
bone, beginning at the head and continuing the pressure 
downward to the extremity of the spine, the patient will 
complain of greater or less soreness of one or more of 
the joints of the back. In some patients the tenderness. 
extends through the whole spine. 

The author ventures to say that he has prescribed 



73 

for not less than five hundred patients with this disease* 
many of whom had suffered many things of several 
physicians and rather grew worse. 

Causes. — This affection is common both to the rich 
and to the poor, to the laborious and the indolent. 
Over-exertion of the bodily powers, excessive uterine 
discharges, derangement of the digestive organs, feeble 
constitution, and occasionally great mental anxiety, 
seem to be occasions of this disease* Among females 
of a laborious life, irritation of the spine is very fre- 
quent and seems to arise from long continued hard 
labor. 

Treatment. — Upon my first acquaintance with this 
disease, I used caustic issues over the spine, afterwards 
repeated blistering, administering internally a pill com* 
posed of three grains of the sun-dried extract of coni- 
um, and four or five grains of the oxide or carbonate 
of iron, three times a day, occasionally increasing the 
dose of the extract to six grains. I had pursued this 
course for several years, when a poor laboring woman 
applied to me for advice with this complaint. I direct- 
ed blistering as usual, but she said that she could not 
afford to abstain from labor to be blistered. I advised 
her to try the pills alone, as possibly they might do her 
some good though they might not cure her. She seem- 
ed to do as well with the pills alone as others with the 
issues and blisters. For several years I have used no 
external remedies. In some cases connected with ex- 
cessive menstruation or other forms of uterine derange- 
ment, I have added the use of Dewees' volatile tincture 
of guiac, (see Recipes,) with manifest advantage and 
also in several where there was no such derangement. 
I have never met with but one case of this disease 
where the above treatment did not cure the patient, and 
that case was greatly relieved. The disease may of 
course be expected to return with a repetition of the 
causes. In that form of neuralgia which attacks the 
face and head, and is called "tic doloreux," I have 
been uniformly successful with the extract of conium 
and iron pill. 

gcf- Be careful to obtain the sun-dried extract, as that 
made by boiling the plant is worthless, 
7 



74 

BLEEDING FROM THE NOSE. 
Apply ice water, or cold water, to the head, hot wa- 
ter and mustard plasters to the feet. Pulverize some 
Alum, (No. 43,) very tine, and blow it through a quill 
into the bleeding nostril. Take a dose of Purging Pills, 
(No. 6,) or of epsom salts, and let all tight clothes be 
removed from the neck. Avoid blowing the nose as 
much as possible. If these remedies fail, it will be 
better to lose a pint of blood from the arm than at the 
nose. 

BLEEDING FROM THE LUNGS, OR SPITTING 
OF BLOOD. 

Symptoms. — This disease is characterized by cough- 
ing up blood of a bright red color and frothy, preceded 
usually by heat or pain in the chest. Sometimes it is 
preceded by a sense of weight and oppression of the 
chest, a saltish taste in the mouth, a dry tickling 
cough, and some slight difficulty of breathing. Spitting 
of blood may come on without any previous symptoms, 
after bodily injury. 

Treatment. — Swallow freely common salt, or two 
or three grains of Sugar of Lead, (No. 42,) with six 
or eight drops of Laudanum, (No. 16,) every half hour, 
or a few grains of Alum, (No. 43,) with fifteen drops of 
elixir vitriol in a wine-glass of water. None of these 
articles should be given at the same time with the 
sugar of lead, as they decompose and destroy its effi- 
cacy. Should there be a considerable raising of blood, 
it will be necessary to bleed at the arm also, to the 
extent of a pint or more. The patient should be kept 
as quiet as possible in body and mind ; use cold drinks 
without stimulants of any kind. Should there be pain 
in the breast, apply a blister over the pain and use a 
spare diet. Ipecac, (No. 47,; in nauseating doses of 
from five to ten grains every half hour or hour, will 
generally check a profuse bleeding from the lungs, and 
irom some other organs of the body almost immediately. 
VOMITING OF BLOOD. 

Symptoms. — A flow of dark blood from the stomach, 
preceded by a sense of weight and oppression in that 



75 

organ. The blood is generally mixed with particles of 
food, &c. 

Causes. — Tumors pressing on the liver, blows, &c. 

Distinguish it from spitting of blood by its dark color, 
and being mixed with food. 

Treatment. — If the accompanying symptoms be in- 
flammatory, bleed, and use some cooling purge ; if other- 
wise, try twenty -five drops of Elixir Vitriol, (No. 14,) 
in a wine-glass of water, every hour, till the bleeding 
ceases, or a weak solution of alum, or a teaspoonful 
of the tonic solution, (see p. 26,) in a wine-glass of 
water. If the cause be a diseased liver, treat it accord- 
ingly. ^ 

HEMATURIA OR BLOODY^URINE. 

This disease is sometimes occasioned by falls, blows, 
bruises or some violent exertion, such as hard riding 
and jumping, but it more usually arises from a small 
stone lodged either in the kidney or in the passage from 
it to the bladder, which by its size or irregularity 
wounds the inner surface of the part it comes in contact 
with ; in which case the blood discharged is most usual- 
ly somewhat coagulated, and the urine deposits a sedi- 
ment of a dark brown color resembling coffee-grounds. 

A discharge of blood by urine, when proceeding from 
the kidney or from the passage to the bladder, is com- 
monly attended by some sharp pain in the back and 
some pain in passing water, the urine which comes 
away first being muddy and high colored, but towards 
the close of its flowing becoming transparent and of a 
natural appearance. When the blood comes immedi- 
ately from the bladder, it is usually accompanied with 
a sense of heat and pain at the bottom of the belly. 
The passing of bloody urine is always attended with 
some danger, particularly when mixed with purulent 
matter. When it arises in the course of any malignant 
disease, it shows a highly putrid state of the blood and 
always indicates a fatal termination. 

When the disease has resulted from violence in a full 
habit of body, bleed to the extent of a pint. Give a 
dose of Epsom Salts. Keep the patient quiet and upon 



76 

a low vegetable diet. If the bleeding proceeds from 
gravel, the best remedy I have known is, 

^ Pour upon this a pint of boiling 
Uva Ursi %i J water. Stir it well together and 

Cremor Tartar |ss > pour it off when it has stood fif- 
Gum Araeic |i 1 teen minutes and sweeten. Dose 

J a wine-glass every hour. 
As this remedy may not be at hand, especially at sea, 
flaxseed tea should be administered freely. A solution 
of the super-carbonate of Soda gave great relief in the 
author's own case. Saleratus, taken m the same form, 
probably would be as efficacious. Fomentations of 
the lower part of the body or a hip bath should also be 
tried. If the attack is not connected with inflammatory 
symptoms, pills of wnite turpentine and balsam copaiva, 
muriated tinct. of iron in the dose of fifteen to twenty 
drops, three times a day in flaxseed tea, will be found 
useful. Fifteen or twenty grains of alum three times 
a day is another excellent and safe remedy. 

ASTHMA. 

This troublesome and sometimes dangerous com- 
plaint commences with great wheezing and shortness 
of breathing, countenance flushed, great anxiety, hollow 
voice and small pulse when lying down. An emetic 
of Ipecac, (No. 47,) relieves the patient as frequently 
as anything else perhaps. The bowels should be freely 
opened by Epsom Salts, (No. 8,) or any other active 
purge. Apply a blister to the chest and put the feet 
into warm water. Let the blister be kept open by 
basilicon ointment, (No. 30.) Give also a dose of fever 
powders, (No. 45,) with about a fourth of a grain of 
Ipecac, every three hours. Sometimes a teaspoonful of 
ether, (No. 21,) will give immediate relief. This may 
be repeated once in half an hour to an hour, if it bene- 
fits the patient. Animal food and all stimulating drinks 
must be abstained from. 

COUGHS AND COLDS. 

The neglect of a slight cold has often led to a fatal 
consumption. Hence it is highly proper to give early 



77 

attention to what may seem to be but a slight cold. One 
of the best remedies is warm boneset tea taken freely 
on going to bed, followed next morning by a dose of 
Epsom Salts, (No. 8.) Should the cold not give way, 

?ive an emetic, either of Tartar Emetic, (No. 1,) or of 
pecac, (No. 47.) Let the feet be bathed in warm 
water before going to bed, and the boneset tea made 
weak be drank freely, and give an antimonial Fever 
Powder, (No. 45,) every three hours in molasses. Give 
a teaspoonful of the cough drops, (see Recipes,) several 
times a day. 

GRAVEL. 
Symptoms. — Pains in the back shooting down to the 
bladder and to the thighs ; sometimes there is a numb- 
ness of the leg and a retraction of either testicle. The 
pains are often violent, and are terminated by the pain- 
ful discharge of small stones. 

Treatment. — Let the patient drink very freely of a 
hot solution of Cream of Tartar, (No. 10,) and of tea 
of Flaxseed, (No. 37.) Let him also take once an 
hour a teaspoonful of Spirits of Nitre, (No. 20,) in a 
little water. The pain must be alleviated by full doses 
of laudanum. Honey taken freely is said to be a good 
remedy in this complaint : but the best remedy I have 
ever used is the infusion of uva ursi, gum arabic, and 
cream of tartar, mentioned in the article on uva ursi, in 
the " Secondary List," page 25. It gives immediate 
relief in the greatest proportion of cases. With some 
patients acids disagree entirely. Saleratus or super- 
carbonate of Soda, in the proportion of a teaspoonful 
to a tumbler of water, drank freely is a more appropri- 
ate remedy. 

DIFFICULTY OF URINE. 

Symptoms. — A frequent desire to make water, attended 
with pain, heat, and difficulty in doing so, — a fullness 
in the bladder. 

Causes. — The urine having been retained too long, 
— Spanish flies taken internally, — gravel, — blisters, and 
all the causes of inflammation of the bladder, — inflamed 
prostate gland, &c. 

7# 



78 

Treatment. — If it arise from simple irritation by 
blisters, &c, plentiful draughts of warm liquids, as 
flaxseed tea, gum arabic or barley water, will be suf- 
ficient to remove it. The infusion of uva ursi, alluded 
to in the chapter upon gravel, is here also a valuable 
remedy. The muriated tincture of iron, in the dose of 
fifteen drops every half hour, has been highly recom- 
mended of late, and in various urinary diseases. If 
from any other cause, a bladder half filled with warm 
water, or cloths wrung out of a warm decoction of 
herbs, should be kept constantly applied over the parts, 
and mild clysters of thin starch be frequently injected. 

SUPPRESSION OF URINE. 

Symptoms. — Pain and swelling of the bladder, — vio- 
lent and fruitless attempts to make water, attended with 
excruciating pain, &c. 

Causes. — The same as in a difficulty of urine. 

Treatment. — As a total suppression of urine is 
always attended with considerable danger, there should 
be no delay in endeavoring to remove it. The first 
step is to bleed the patient, who should immediately 
after be placed in the warm bath. While he is there, 
a laxative and anodyne clyster must be got ready, 
which is to be given as soon as he leaves it, and fre- 
quently repeated. In the mean time the warm fomen- 
tations, and a bladder of hot water must be kept 
applied, and a cup of flaxseed tea be taken with a tea- 
spoonful of Ether, (No. 21,) and 20 drops of Laudanum, 
(No. 16,) be taken every three or four hours. If there 
be any difficulty in procuring it, twenty drops of lauda- 
num in a little warm barley or rice water, will answer 
instead. Warm sweet oil, or milk and water, may be 
injected up the urethra, and 6 or 8 grains of camphor, 
or one or two teaspoonsful of Spirits Camphor, (No. 
26,) in a little milk, be taken every hour. 

If no relief is obtained by these means, apply snow 
or ice to the bladder, or make the patient stand on a 
cold brick or stone pavement, and dash cold water over 
his thighs ; and if this fail, r try the tobacco clyster, (see 
Rupture,) which sometimes succeeds after everything 
else has been resorted to in vain. If a catheter can be 



79 

procured, try to pass it into the bladder while in the 
bath. If the patient himself cannot do it* let a handy 
friend attempt it ; if foiled in one position, try another, 
— success is of the utmost importance, for there is 
nothing but an operation, in the event of its not being 
obtained, can save life. 

In every case of suppression of urine, the order of 
remedies then is, blood-letting, — the warm bath, — laxa- 
tives and anodyne clysters, — -fomentations, or bladders half 
filled with warm water over the lower belly, camphor and 
milk every hour, — passing the catheter, — dashing cold 
water over the thighs and legs, or applying snow or ice to 
the bladder, and lastly, the tobacco clyster. 

PILES. 

Symptoms. — A pain in the fundament when going 
to stool. On examination small tumors are perceived 
projecting beyond its verge. They are of two kinds, 
the blind and bleeding. They may be also internal 
and external. 

Treatment. — When the loss of blood is considera- 
ble, it may be checked by the application of ice or 
cold water, or a solution of Alum, (No. 43,) to the fun- 
dament, or by pressure upon the part. A grain or two 
of White Vitriol, (No. 41,) may be taken three times a 
day in water, and the bowels kept open with Sulphur, 
(No. 9,) or mixed with Cream of Tartar, (No. 10,) or 
Castor Oil, (No. 12.) For the other kind of piles, 
let an ointment be made by rubbing fine half a teaspoon- 
ful of Sugar of Lead, (No. 42,) mixing it thoroughly 
with about one ounce of lard, of which a piece of the size 
of a hazlenut may be rubbed on the fundament night 
and morning ; or lard simmered with a little tobacco 
may be used in the same way. Sixty drops of Balsam 
Copaiva, (No. 24,) three times a day, is an excellent 
remedy for this form of piles of long standing. 
SCURVY. 

Symptoms. — A sense of heaviness, weariness, reluc- 
tance to move about, low spirits, loss of strength. The 
face becomes sallow, bloated, the breathing is hurried 
by the least exertion, the teeth loosen, the gums become 

* See directions, &c, for passing bougies and catheters. 



80 

spongy and purple, the breath foul, dark spots appear 
on the body, old wounds break out afresh, severe wan- 
dering pains are felt, particularly by night, the skin is 
dry, the urine scanty, pulse small, frequent, and 
towards the last intermitting. Other dangerous symp- 
toms follow until death closes the scene. 

In the cure as well as the prevention of scurvy, 
much more is to be done by diet, habits, &c, than by medi- 
cine. Fresh provisions, a large proportion of them 
vegetable, acid, fruits, vinegar, spruce beer, cider, a 
beverage of Cream of Tartar, (No. 10,; mineral acids, 
such as Elixir Vitriol, (No. 14,) fifteen or twenty drops 
thrice a day in half a tumbler of water. The same is 
a good wash for the gums. A grain of quinine, one of 
the Powders, (No. 48,) may be given with the elixir 
vitriol, or a wine glass of the decoction of bark, (see 
Recipes.) The stiffness of the limbs may be relieved 
by hot fomentations of chamomile tea, and by rubbing 
them with a dry hand or a little oil. In hot climates 
burying the larger portion of the body in the ground 
gives speedy relief. Citric acid or the salt of lemons 
ought to be on board of every vessel bound on a long 
voyage, as it is one of the best preventives and reme- 
dies, and may be preserved any length of time. A 
pleasant beverage is made by dissolving a very little in 
water and adding sugar. 

ITCH, 

Appears first on the wrists and between the fingers 
in pimples with watery heads. Mix Sulphur, (No. 9,) 
and lard into an ointment, in the proportion of half 
as much such sulphur as lard, and rub it upon the pim- 
ples before a fire, taking at the same time internally two 
teaspoonsful of sulphur in molasses. Let this be re- 
peated three successive nights, or rub a piece of Mer- 
curial ointment, (No. 31,) on the wrists, groins and 
hams, and wherever it appears night and morning, and 
avoid cold and moisture. 

VERMIN, 

Such as lice, or crabs, as they are commonly called, 
are destroyed by rubbing upon the part a very small 
quantity of Mercurial Ointment, (No. 31.) 



MIDWIFERY. 



Many cases of childbirth on board of vessels have 
come to the author's knowledge where no professional 
aid could be obtained. In accordance with the express- 
ed wish of many ship-masters, and with the author's 
own views of propriety, he has subjoined a few simple 
directions in cases more to be dreaded at sea than a 
gale of wind. 

Previous to any particular directions, it is well to 
remark that the various stages of labor are a perfectly 
natural process, rarely needing interference. It is esti- 
mated that not more than one case in one hundred and 
fifty to two hundred needs the interposition of art. 
Nature, under the arrangements of Divine Providence, 
is capable of overcoming obstacles of a most serious 
character. 

The first sign of labor usually is pain, sometimes 
slight, sometimes sudden, severe cutting pains from the 
lower part of the bowels to the back and the reverse. 
These continuing for a longer or a shorter period grad- 
ually change to those of a bearing down character. 
This is generally indicated by a more subdued tone of 
voice in the cries of the patient. At the last point of 
the process the patient suffers extremely, and indicates 
her agony by a peculiar cry. It is at this point only, 
in general, that assistance begins to be needed. 

The patient should have her night dress drawn up, 
and pinned around the waist to prevent it being soiled, 
and a sheet in its place pinned around the body. Let 
her lie upon her left side upon some thick or folded 
covering, that will not be injured by the discharges, 
and that can be readily removed. Let her knees be 
somewhat drawn up, her back to the attendant. She 
should be allowed a handkerchief, a rope or twisted 
sheet fastened at one end, to hold on to during a pain. 



82 

Should there he an inclination to pass anything from 
the howels or bladder, it should not be resisted. 

After the pains have continued some time, the waters, 
as they are called, break and come away, and the head 
of the child almost immediately comes nearer to the ex- 
ternal parts. As the child's head, which is the part 
most frequently presented, begins to protrude and press 
upon the parts between the two passages, let a soft 
cloth, or a towel, or a diaper, be folded and applied 
upon the palm of the hand with considerable pressure 
to the parts stretched by the head, in order to prevent 
any rupture by a too rapid delivery of the head of the 
child. 

Let this pressure be continued until the head is born. 
Support the head and body of the child as they success- 
ively come into the world with the left hand. As soon 
as the child is born bring it out from under the bed- 
clothes. If the cord or navel-string is wound round 
its neck, remove it immediately. If the child is healthy 
it will begin to breathe, and with its first breath will 
begin to cry. When the action of the lungs is well 
established by the child's crying, tie the navel-string 
closely with a piece of narrow tape, twine, or any con- 
venient string, about an inch from the navel, and with 
a pair of scissors, if you have them, cut the cord about 
half an inch above the ligature, and let the mother's end 
of the cord bleed into a basin. If in the course of ten 
or fifteen minutes the patient does not discharge the 
after-birth, wind the navel-string around the two first 
fingers, and gently draw upon it for a minute or two. 
Be careful not to break it. When you feel the after- 
birth in the lower part of the passage, it may be hooked 
with the finger, and slowly drawn out and deposited in 
a basin. 

The child being properly cared for, use gentle fric- 
tion with the hand upon the bowels of the mother, to 
induce the womb to contract. Then apply a towel, a 
diaper, or any firm cloth, as a bandage on the hips and 
lower part of the bowels over the chemise, and pin it 
pretty closely with four or five pins. A folded diaper 
or cloth should be applied to the passage to retain the 



83 

discharges. Remove the soiled coverings, let the dress 
of the patient be brought down to its proper place. 
Her diet should be light for four or rive days. 

She should take a dose of castor oil or calcined mag- 
nesia on the third day. If after-pains attack give one 
to two teaspoonsful of spirits camphor, (No. 26,) and 
twenty- five drops of laudanum, (No. 16,) or from one- 
fourth to half a grain of morphine. 

CARE OF THE CHILD. 

The child should be anointed with lard or sweet oil 
in order to remove a white scurf which more or less 
covers the skin of the new-born infant, and which soap 
alone will not remove. When the scurf is well rubbed 
with the oil, wash the whole body with soap and luke- 
warm water. Bind up the navel string as you would 
a sore finger, — lay it against the belly, and put a band 
around the bowels to keep it securely. 

Put the child to the breast as soon as dressed, and 
the mother is made comfortable, that the instinct with 
which children are born, leading them to nurse, may 
not be lost. Give the child two or three teaspoonsful 
of molasses and water, and every morning a teaspoon- 
ful of cold water. This last is to prevent the sprue or 
sore mouth. The bowels must be carefully attended to 
until the color of the stools change from the dark, tar- 
like matter to yellow. 



FEMALE DISEASES. 



It is not the intention of the author to enter exten* 
sively into the subject of female complaints, but to give 
a few simple directions to females whose sense of mod- 
esty often prevents application for professional advice. 
I have been led to this also by the request of a number 
of shipmasters on board of whose vessels great numbers 
of emigrants take passage. As in the case of other dis- 
eases treated of in this edition, some of the remedies are 
not included in the regular medicine chest list. 

ABORTION OR MISCARRIAGE. 

The frequency of miscarriages on board of vessels, as 
well as upon the land, seems to justify a few plain di- 
rections for such emergencies. 

Causes.-— These are constitutional and incidental. 
The remarks that follow refer more particularly to the 
latter. Miscarriages result from sudden shocks or falls, 
from a blow upon the bowels, from violent muscular 
exertions, immoderate exercise, strong mental excite- 
ment, and various other causes. 

Symptoms. — The chief symptoms of threatened mis- 
carriage are short sharp pains in the back and lower 
part oi the bowels, or sudden loss of blood from the 
womb. 

Treatment. — This consists of two parts, viz : the 
prevention of abortion when threatened, and the safe 
conduct of the patient through it, when we have reason 
to conclude that it has occurred. The first step is to 
place the patient upon her back. If she is of a robust 
constitution, if an accident or severe exercise in long 
walks, running, or the motion of a ship, &c, has 
brought on the difficulty, three-fourths of a pint to a 



85 

pint of blood should be taken from the arm if there is 
any person at hand competent to perform the operation. 
A full dose of laudanum, (No. 16,) even to the extent of 
forty to sixty drops, should be immediately adminis- 
tered, or two grains of solid opium. Forty drops more 
of the laudanum should be given three or four hours 
after, if the symptoms continue. The bowels must be 
moved by the laxative injection. The patient should 
be kept as quiet as possible, in mind and body, and 
carefully avoid undue warmth from the bed or bedding. 
If there should be a considerable discharge of blood, the 
pains become regular and extend around the body, with 
a sense of bearing down, there is little hope of avoid- 
ing abortion. The flooding may increase and the pa- 
tient become faint and appear to be sinking. It rarely 
happens, however, that she does not soon recover 5 but 
should she faint away the discharge would perhaps be 
more effectually stopped. Cold drinks, cloths wrung 
out in cold and even ice water, must be laid upon the 
bowels and between the thighs. Should the flow of 
blood be checked, the cold applications should be laid 
aside. If the discharge is excessive, it may be neces- 
sary to stop the passage by introducing a silk handker- 
chief or some other soft cloth well smeared with lard 
or oil, of sufficient size to stop the bleeding. If the 
bleeding comes on after the contents of the womb are 
discharged, full doses of laudanum and the cold appli- 
cations must be employed. The directions given under 
the head of Uterine Hemorrhage are also appropriate 
to these circumstances. 

SUPPRESSION OF THE MENSES. 

This affection occurs from cold, grief and other de- 
pressing passions, an idle, luxurious life, abuse of acids, 
&c. It is sometimes a symptom of consumption. 

When the discharge has been for some time inter- 
rupted, especially in persons previously healthy, bleed- 
ings will often occur from the lungs, the stomach or the 
nose. The patient usually becomes very costive and 
dyspeptic. Colicky pains and hysteric symptoms are 
a common attendant. 
8 



86 

Treatment. — If the patient is of a robust constitu- 
tion, and a full habit, she may be bled from the arm, 
from half a pint to a pint. The hips and lower part of 
the bowels should be fomented by flannels wrung out 
in hot water * the patient should every day sit down in 
a tub of warm water for fifteen minutes or more/ 
Bathing the feet, also, is always useful. There are a 
great variety of remedies in professional and popular 
use. Among the latter perhaps none are superior to the 
infusion of tanzy. 

A wine-glassful of it, three or four times a-day, for 
several days, or even a month, is a proper dose. Tinc- 
ture of myrrh, in the dose of a teaspooniul thrice a day ; 
half a teaspoonful of carbonate, or filings of iron, and 
any form of iron almost, are good remedies. I have 
prescribed to more than five hundred patients, with 
scarcely a failure of success, the Female Pills. (See 
Recipes.) They can be made up at any apothecary 
store. 

A preparation well known to physicians, but not 
ordinarily kept on hand ill apothecary shops, called 
Dewees' Volatile Tincture of Guiac, is the next best re- 
medy. Dose, one or two teaspoonsful in sweetened 
milk or water three times a day. Griffith's Myrrh Mix- 
ture is another efficacious combination for suppressed 
menstruation. Recipes for all these medicines will be 
found on a previous page amongst other formulas. 
Boneset, (No. 49,) three times a day, will frequently 
answer every purpose when other more convenient re- 
medies are not at hand. The " Tonic Solution" is also 
an efficient remedy. 

EXCESSIVE MENSTRUATION. 

Symptoms. — This affection may exist in two forms, 
viz. : menstruation occurring regularly once in four 
weeks, but excessive in quantity, or at lesser intervals, 
and also in too great quantity. Under both, the patient 
becomes debilitated, the face pale, the pulse feeble, and 
exercise occasions unusual fatigue, the extremities be- 
come cold, the feet and ankles swell towards night, the 
patient suffers from pain in the back in an erect position. 



87 

and is affected with various dyspeptic symptoms. By 
long continuance of the excessive discharge, that un- 
comfortable disease, falling of the womb, ensues. 

Causes. — A relaxed state of the system, owing either 
to hard labor and poor diet, or to an indolent, luxurious 
mode of life, and to some other causes. 

Treatment. — The best remedy I have found is the 
guiac tincture mentioned in the previous chapter. The 
" Tonic Solution" is also very good in the dose of a 
teaspoonful three times a day. Gum kino in the dose 
of from five to ten grains, three or four times a day, 
will also be found useful. The muriated tincture of 
iron, in the dose of fifteen tot wenty drops in a wine- 
glass of sweetened water, thrice a day, and iron in most 
any of its forms, taken for some time will bring about a 
happy change. These remedies are liable to be follow- 
ed by costiveness, which should be obviated by such 
laxatives as cream of tartar, (No. 10,) or calcined mag- 
nesia, (No. 5,) or Seidlitz powders. Should the dis- 
charge be very excessive, astringent injections should 
be employed, as one or two teaspoonsful of white vitriol, 
(No. 41,) dissolved in a pint of water. 

Early hours and moderate exercise, and cold sea 
bathing, are important matters to be observed in this 
complaint. 

UTERINE HEMORRHAGE, OR BLEEDING FROM 
THE WOMB. 

This affection may arise from violence, over-exertion 
of the body from violent emotions of the mind, abortion, 
and other causes. Particular directions for those cases 
which proceed from abortion will be found in the chap- 
ter upon that subject. 

Treatment. — Let the patient be kept as quiet as 
possible in a horizontal posture. Cloths should be 
wrung out in cold, and even in ice water, and placed 
upon the lower part of the bowels and between the 
thighs, and repeated as they grow warmer. The drink 
of the patient should be cold, and the diet of the lightest 
kind. Should these means not check the discharge, 
and especially if it should increase, blood-letting to 



88 

the extent of a pint must be resorted to, if any one 
can be found to perform the operation. Rub up twelve 
grains of sugar of lead, (No. 42,) and one grain of 
opium, and divide into four pills or powders, and give 
one in molasses every half hour until the discharge 
ceases, or the doses are all taken. Three grains of 
sugar of lead, and eight drops of laudanum, (No. 16,) 
may be administered when solid opium is not on hand. 
These medicines must be followed within six hours by 
a dose of castor oil. In this form of hemorrhage and 
some others, ipecac, (No. 47,) is a valuable remedy, 
even when given so as to occasion vomiting. A dose 
often grains, repeated in half an hour, or an hour, so 
as to nauseate without vomiting, is perhaps to be pre- 
ferred. The "Tonic Solution," a teaspoonful every 
hour, may also be used. 

LEUCORRHGEA, OR WHITES. 

This disease is so well known to the sex, that a 
particular description is omitted from motives of deli- 
cacy. 

When it has long continued it leads to great general 
debility and to weakness of the parts affected. The 
cure of it then is very difficult. 

Treatment. — The constitution of the patient must 
be strengthened by suitable medicines, and the parts 
affected, by local applications. Among the former are 
the various preparations of iron, as the muriated tinc- 
ture of iron, twenty drops three times a day; the car- 
bonate or the oxide of iron, in half teaspoonful doses 
in syrup, three or four times a day. The " Tonic So- 
lution," " Dewees' Tincture," the " Female Pills," and 
the myrrh mixture (see recipes) are all excellent medi- 
cines in leucorrhcea. The mixture or the tincture may 
be used at the same time with the pills. Among the 
more recently discovered medicines perhaps none will 
be found superior to the hydriodate of potash. (See 
page 25.) It is necessary to continue the use of these 
medicines for some time to produce the desired effect. 
The second class of remedies consists of various 
washes administered with a iemale syringe. A suita* 



89 

ble wash may be made by dissolving two drachms 
each of alum and white vitriol in a pint of water, 
which should be applied four or five times a day. A 
strong decoction of white oak bark, and of green tea, 
may also be employed in the same way. Nitrate of 
silver, commonly called lunar caustic, is probably a 
better remedy than any of these. If it were to be 
applied in its solid state directly to the whole surface 
affected by the disease, it would produce an immediate 
and favorable change. This operation would require 
the attendance of a physician and the use of peculiar 
instruments. If, however, half a drachm of the caustic 
were dissolved in half a pint of pure rain or river 
water, and used with a glass or ivory syringe so that 
the solution should reach every portion of the surface 
affected, it probably would answer every purpose of 
the solid caustic. It should be employed three or four 
times a day for two or three days, and followed after- 
wards by a solution of a drachm of sugar of lead, (No. 
42,) or of white vitriol, (No. 41,) morning, noon and 
night. The caustic is rather a severe remedy, but an 
efficacious one. Care should be taken lest it indelibly 
stain the linen of the patient. 

A nourishing diet, regular and early hours, with the 
cold bath at proper seasons of the year, are matters to 
be attended to in order to derive all the advantages of 
the other treatment. 

PROLAPSE, OR FALLING OF THE WOMB. 

It does not consist with the design of this work to 
enter particularly into a consideration of this uncom- 
fortable disease. A few general and plain directions, 
which the author has found useful in many cases, he 
hopes will be found useful to such as may consult this 
manual on their own case. 

If the prolapse is the result of sudden injury, the 
womb is to be replaced by the hand of an assistant, 
and the body kept for a time in a horizontal position. 
If the complaint proceeds from a relaxed state of the 
parts, from leucorrhcea and other debilitating causes, 
the bowels must be supported by a proper bandage or 



90 

by some of the abdominal supporters so common at this 
day among truss manufacturers. A wash made by 
dissolving two drachms each of white vitriol, (No. 41,) 
and alum, (No. 43,) in a pint of water should be thrown 
up several times a day with a female syringe. 

The principal remedies which I have been accus- 
tomed to administer internally are the myrrh mixture 
and "Dewees' Volatile Tincture of Guiac," continued 
as before prescribed, for three or four weeks. 



DISEASES OF CHILDREN. 



The difficulty of acquiring a knowledge of the dis- 
eases of children, on account of their incapability of 
making known their sensations by language, has by 
some physicians been made an excuse for neglecting 
the subject of infantile diseases. This very difficulty 
is an argument in favor of committing it to men of in- 
tellect and science. 

Although children cannot communicate their sensa- 
tions by language, the symptoms by which we deter- 
mine the seat of the disease are more uniform in their 
appearances and more certain in their indications than 
in adults, neither their habits, their false delicacy, fear 
nor anxiety, influencing them. Particular attention 
should be paid to what passes from their bowels. A 
very large proportion of their diseases originate from 
disordered secretions of the stomach and bowels. 
Their nervous system is more easily excited by causes 
of irritation, such as worms, teething, acrid and indi- 
gestible substances in the stomach and bowels, than 
that of adults. 

There exist in some classes of society strange and 
absurd ideas respecting the management of infants. 
They suppose that some children are born with a strong 
appetite for a particular kind of food which the mother 
had a longing for before birth, and that they will die 
unless they have it. I recollect one case where mince 
pie was given to a new-born child that cried a great 
deal. Fatal consequences have resulted doubtless 
from such errors. 

Medicines are not to be given to children to prevent 
diseases, nor are they to be given merely to produce 
evacuations, but an excitement counter to the diseased 
action. Too much nursing is as injurious almost as 



92 

too little. I have no doubt that many children are 
nursed to death. 

The limits of this work will not admit of extensive 
remarks under this head. Some of the diseases, com- 
mon both to children and adults, have already been 
noticed in the previous pages. The following lines 
may prove serviceable until the attendance of a physi- 
cian can be obtained. 

RETENTION OF THE MECONIUM. 

The meconium is the matter found in the bowels at 
birth, viscid, and of a dark green color. Ordinarily, if 
the child is put to the breast immediately after dressing, 
the first milk of the mother will operate as a purgative. 
If it should not, give the child a few teaspoonsful of 
cold water strongly sweetened with molasses. 

All the diseases of the first month, if no other cause 
is evident, should be suspected to arise from the reten- 
tion of the meconium. Severe paroxysms of pain in 
the bowels, indicated by crying, writhing, swelling of 
the bowels, convulsions, epileptic fits, &c, arise from 
this cause. Lockjaw is a very common consequence 
in the West Indies. The first thing to be done in all 
these cases, is to evacuate the bowels. A teaspoonful 
of castor oil is usually sufficient for this purpose. If 
this is vomited up take of 

Senna leaves, 5i- one drachm, 

Manna or coarse Sugar, §ss. half an ounce, 
Water, i a pint, 

boil it down one half, and feed the child freely until 
the bowels are moved. The operation of cathartics 
may be forwarded by injections of catnip, chamomile, 
or other aromatic tea. It is not unfrequently proper 
during the first month to administer mercurial purges. 
The blue pill, (No. 7,) in the dose of one or two dis- 
solved in a teaspoonful or two of breast milk, is gener- 
ally sufficient. Should this not act sufficiently, calomel, 
(No. 3,) in the dose of from four to eight grains, should 
be administered. There is no danger of salivating 
young children. Owing to the mucus or slimy matter 
of the bowels, children will often require as large a 



93 

dose of calomel as adults. When convulsions are 
present the warm bath should be used with cathartics 
in full doses. 

THRUSH, OR SPRUE. 

This disease frequently appears within the first 
month, but it may, almost universally, be prevented by 
giving a teaspoonful of cold water soon after birth, 
repeating it every morning, and keeping the bowels 
open. 

Symptoms. — It commences with white specks upon 
the lips and corners of the mouth, and on the tongue. 
Sometimes the whole inside of the mouth is covered 
with these specks, and of increased size, extending to 
the throat, and also through the whole length of the 
bowels. The child is, commonly, very drowsy before 
the specks appear. 

Treatment. — Mix six grains of Ipecac, or one fourth 
of one of the powders, (No. 47,) in six teaspoonsful of 
warm water, and give one teaspoonful every ten 
minutes, until the child vomits freely. From half to a 
whole teaspoonful of Calcined Magnesia, (No. 5,) 
should follow the ipecac, unless the bowels should be 
freely opened by the ipecac. After the bowels have 
been moved, give the child $ grain of ipecac, or a little 
upon the point of a penknife, once in three hours. 
The tonic solution, (see Recipes,) in the dose of from 
twenty to forty drops three times a day, is an excellent 
medicine in this disease, and is to be given - after the 
stomach and bowels have been evacuated. Castor Oil 
should not be given for the sprue. The author never 
lost a patient who took ipecac, as above directed. 

COSTIVENESS. 

Children who nurse the bottle, or who are fed with 
a spoon, are apt to be costive. Pure cow's milk is too 
strong food for young infants, and should be reduced 
one-third with water, and boiled with a little white 
sugar. The use of oatmeal gruel will often keep the 
bowels regular. If the infant is young, this would be 
an unsuitable diet. If medicine should become neces* 



94 

sary, divide one of the Mercurial Pills, (No. 7,) into 
four parts, and give one part night and morning, dis- 
solved in milk, for three or four days. Dandelion or 
mullen tea, fed freely, is a good remedy. Some nurses 
introduce a piece of molasses candy into the extremity 
of the bowels, to break up a costive habit. If costive- 
ness is allowed to continue, the patient will probably 
be affected with convulsions. 

CONVULSIONS, OR FITS. 

Put the patient immediately into a warm bath. 
While the bath is preparing, dissolve two teaspoonsful 
of common salt in half a pint .of water, and give it as 
an injection, and repeat until the bowels are well 
moved. As soon as the child can swallow, give ten 
grains, or two-thirds of one of the papers of Calomel, 
(No. 3,) in a little molasses. If the fits are owing to 
improper food, administer from six to ten grains of 
ipecac, as directed above in Sprue. If from teething, 
lance the gums, and apply one to two leeches to each 
temple, if they can be procured, and act on the bowels 
as directed above, or by senna and salts. From 5 to 
10 drops of Hartshorn, (No. 17,) should be given in a 
teaspoonful of water, and repeated in half an hour, 
and mustard, or horse-radish leaves, applied to the 
feet. A teaspoonful of saleratus or pearlash, in a half 
pint of water given by injection, is often a powerful 
remedy in fits. 

If the spasms continue after the use of the above 
remedies, give Laudanum, (No. 16,) one drop, if the 
child is under a month old, and from two to four drops 
— according to the increase of age. 

DIFFICULT TEETHING. 

Symptoms. — Fretfulness, inclination to bite hard sub- 
stances, slavering, starting in sleep, eruptions about 
the mouth and head, flushing of the face, diarrhoea, 
frequent vomiting, irregular and green stools, bloating 
of the hands and face, convulsions. 

Treatment. — Lance the gums down to the teeth, 
give the child some hard substance to bite upon, or 



95 

rub the gums with hard and polished substances. Ex- 
amine carefully, to ascertain if any other disease affects 
the system, and if so, use the proper means to remove 
it. Put the child into a warm bath, and use other 
remedies to promote perspiration. Give the child 10 
grains of Calomel, (No. 3,) if there is no diarrhoea. It 
is unsafe to stop a diarrhoea if one exists. If it is very 
severe, it may be moderated. Costiveness should 
never be allowed to exist. The bowels may be kept 
open by Castor Oil, (No. 12.) If the stools are green, 
give the recipe under the head of diarrhoea, (page 94,) 
one teaspoonful thrice a day. If the head is hot, put 
the feet in warm water, apply blisters behind the ears, 
and a ginger or mild mustard plaster to the feet. In 
severe cases of teething, there is great danger of dropsy 
of the brain. The warm bath is an excellent remedy 
for children in almost any stage of teething. It is very 
common for children, when teething, to be affected 
with eruptions behind and about the ears. It is unsafe 
to heal these eruptions until the teeth are all cut 
through. 

VOMITING. 

All healthy infants vomit more or less. When it is 
inordinate, and arises from disease, it should be checked. 
Eight or ten grains of Ipecac, (No. 47,) in divided 
doses, given once in ten minutes, will frequently check 
it. If not give the rhubarb and magnesia, or chalk 
mixture, &c, as directed under "Diarrhoea;" apply 
cloths wrung out in hot water, or ginger or mustard 
plasters, to the pit of the stomach. Sometimes eight or 
ten grains of Calomel, (No. 3,) will stop the vomiting 
immediately. Let the bowels be moved by injections 
of salt and water. If all these fail, use the warm 
bath. 

WORMS. 

Symptoms. — These are rather uncertain, and are such 
as are produced by other causes. The most common 
are offensive breath, frequent rubbing of the nose, 
itching of the fundament, voracious appetite, swelling 



96 

of the bowels with wind, white milky or slimy stools, 
sleepiness, particularly after eating, bloated face, fre- 
quent flushing of the face, irregular pulse, palpitation 
of the heart, starting in sleep, grinding of the teeth, 
suffocation, convulsions,. &c. 

Treatment.— The long round worm is the most com- 
mon in children, and should be treated with strong 
purges. 10 to 15 grains of Rhubarb, and 8 to 10 
grains of Calomel, will generally prove efficacious, 
especially if repeated within a day or two. Alum 
whey has sometimes destroyed them. One or two of 
the Purging Pills, (No. 6,) reduced to powder and 
given in molasses, may be administered. Among the 
remedies not usually put into/ medicine chests, are 
Carolina Pinkroot, Cut Hair, Cowhage, Oil of Worm- 
seed, Elixir Proprietatis, Common Salt. Half an ounce 
of the pinkroot may be steeped in half a pint of boil- 
ing water, and given freely through the day, and at 
night a purge either of the Pills, (No. 6,) or 10 grains 
of Calomel,. (No, 3,) or senna, and manna. 

The small pin worms have their location mostly in 
the extremity of the bowels, and are more difficult of 
removal by medicines taken by the mouth. All strong 
purges should be avoided except calomel. 

Among the best remedies for this kind of worms are 
injections of two teaspoonsful of Spirits Camphor, 
(No. 26,) and half a pint of milk repeated several 
times. Aloes one quarter of an ounce, and milk or 
water half a pint, is another good remedy. A strong 
decoction of walnut or butternut bark, given freely by 
the mouth, is useful in discharging these worms and 
in preventing their return. Children who eat a great 
deal of salt with their food are rarely affected with 
worms. 

DIARRHOEA. 

This disease may arise in children from a bad con- 
stitution, warm damp rooms, confinement, exposure to 
cold and moisture, improper food, and want of cleanli- 
ness. 

Treatment. — If the disease be but of few days' 



97 

standing, the following may check it at once. Take of 
Powdered Rhubarb, 8 grains, 
Calcined Magnesia, 30 grains, 
Powdered Gum Arabic, a drachm, 
Essence of Cinnamon ) ., A -, . 

or Peppermint, ) 10 dro P s ' 

Carbonate of Soda, or 
Saleratus, 5 grains, 
Cold water, 2 large spoonsful. 
Mix. Dose a teaspoonful every half hour until it 
operates. 

If the disease is accompanied with fever, an emetic 
of Ipecac, (No. 47,) should commence the treatment. 
Mix from five to ten grains in a large spoonful of warm 
water, of which give a teaspoonful every ten minutes. 
If the child be not of very delicate constitution, eight 
grains of Calomel (No. 3,) should next be administered. 
If the child is feeble, two of the blue mercurial pills, 
(No. 7,) should be dissolved in a little milk or water 
and given at one dose. Be careful of the diet of the 
child, which should be light, such as arrow-root, flour- 
porridge, with equal parts of milk and lime-water, if to 
be obtained. 

If the pulse is small, the skin and extremities cold, 
the warm bath and flannels next to the skin should be 
immediately applied. If vomiting comes on, apply 
mustard or warm poultices to the pit of the stomach, 
injections of salt water, catnip or pennyroyal tea. 
Sometimes eight or ten grains of Calomel will quiet 
the stomach more speedily than anything else. If de- 
bility ensues, administer the Tonic solution and the 
chalk mixture (see Recipes) once in three hours. Small 
doses of Ipecac, one eighth or one quarter of a grain, 
every two or three hours, acts both as a tonic and as- 
tringent. 

If the stools should be green or of a curdled appear- 
ance, lime-water, chalk, or the Rhubarb mixture men- 
tioned above, should be given every two or three 
hours. The expressed juice of fresh spearmint boiled, 
skimmed, sweetened with white sugar and fed freely 

9 



98 

to the child, gave immediate relief in two bad cases 
under my own charge. 

If the stools are white or clayey, mix up a blue pill, 
(No. 7,) with one drop of Laudanum, as much Ipecac, 
as you may take up on the point of a penknife, and 
give it in a teaspoonful of milk or water, once in six 
hours to a child a year old and under, and increase the 
laudanum to three drops, according to age. If the 
bowels swell and are affected with griping, give fre- 
quent injections of Chamomile tea. 

Should the looseness continue from day to day, and 
become a habit, decoctions of astringent barks, roots, 
&c, such as white oak bark, blackberry and hard 
hack root, should be given several times a day. 

The Tonic Solution is an excellent remedy, and may 
be continued a long time with advantage. 

CHOLERA INFANTUM OR SUMMER COM- 
PLAINT. 

This disease in the Northern States makes its ap- 
pearance in the months of July, August, September and 
October. Cases of it are rare in the latter month. 

Symptoms. — It usually commences with diarrhoea, 
which continues sometimes for weeks without any 
alarming symptoms. At other times, the attack is by 
violent vomitings attended with high fever. The dis- 
charges from the bowels present a great variety of ap- 
pearance. Sometimes they are very offensive. The 
disease is accompanied by fever, great restlessness, 
often by severe pain, increased by paroxysms with in- 
tervals from fifteen minutes to two hours. The pulse 
is usually quick and weak, the head hot, and the hands 
and feet cold. The patient is generally thirsty and 
vomits immediately after drinking — the eyes often ap- 
pear languid and hollow, the child sleeps with his eye- 
lids half closed. Sometimes the vomiting ceases for 
several days and then returns again, the looseness con- 
tinuing. Sometimes the discharge is fatal in 48 hours, 
and sometimes also it continues for months. 

Treatment. — When the disease comes on with 
vomiting and purging, like Cholera Morbus, the stom- 



99 

ach and bowels will be sufficiently emptied. If only with 
vomiting, an emetic of Ipecac, (No. 47,) dose from six 
grains to twelve, w r ill frequently check the vomiting at 
once. This should be followed by 8 to 10 grains Calo- 
mel, (No. 3,) unless the constitution of the child is ex- 
ceedingly delicate. Strong peppermint or cinnamon 
water should be given also to quiet the stomach, and 
ginger moistened with strong spirits, applied to the pit 
of the stomach. If the stools are frequent, administer 
anodyne injections, {see Recipes,) of half a wine-glass of 
thin starch to four or fi\e drops of Laudanum, (No. 
16,) to a child under a year old, arid 8 drops if two 
years, 25 drops to a patient 10 or 12 years of age. 
A single dose of calomel at the very commencement 
of the attack will sometimes quiet the whole system 
at once. Flannels of several thicknesses wrung out 
in hot water, laid on as hot as can be borne, frequently 
repeated, are an excellent application. Burdock leaves, 
horse-radish leaves, and other articles of the kind, bruis- 
ed, heated on a shovel, or otherwise, and laid upon 
the bowels, are also excellent remedies. If the dis- 
ease continues, mix two grains of Ipecac, (No. 47,) 
and five drops of Laudanum, (No. 16,) with eight tea- 
spoonsful of cold water, and give a teaspoonful of the 
mixture every three hours to a child under one year. 
The laudanum may be increased according to the age 
of the patient. 

CROUP. 

This disease is of a most dangerous character. If 
suffered to pass beyond the first stage, it is almost cer- 
tainly fatal. Whatever is done, therefore, must be 
done immediately. 

Symptoms. — It comes on usually quite suddenly, and 
is characterized by a laborious breathing and a pecu- 
liar shrill cough, as if the patient was breathing or 
coughing through a brazen tube. At other times it. 
comes on much more gradually, the child appearing 
dull and fretful, for a day or two the eyes are heavy. 
As the disease advances there is a convulsive struggle 



100 

in breathing, the child throwing back his head with 
some force. 

Treatment. — Give an emetic of ten to fifteen grains 
of Ipecac, or one-third or more of the contents of one 
of the Papers, (No. 47,) with ten drops to sixty of An- 
timonial Wine, (No. 28,) according to the age of the 
patient, until full vomiting is produced, bathe the feet 
and legs in warm water, apply leeches, if they can be 
procured, to the throat, or a poultice sprinkled with a 
little mustard. Give as soon as convenient a ten grain 
dose of calomel. The neck may be rubbed with Harts- 
horn, (No. 17,) frequently. Should the disease not 
yield, apply a blister to the neck. Let the syrup of 
Squills, (No. 22,) with five or six drops of antimonial 
wine, be given every three hours. 

Should the symptoms return, renew the emetic, and 
other remedies. If a physician can be procured, secure 
his attendance as early as possible, but commence 
the treatment above described, without waiting for his 
arrival. 

REMARKS UPON CHILDREN'S DISEASES. 

The diseases of young children are in general simple 
in their character. They arise, chiefly, from derange- 
ment of the stomach and bowels. Improper food is 
the most frequent source of disease in early infancy, 
occasioning wind, pain, diarrhoea, green stools, &c. 
These last show the existence of acidity in the stomach 
and bowels, and are to be corrected by lime water, 
magnesia, or magnesia and rhubarb, in the form direct- 
ed under the head of diarrhoea. 

Many a mother spends sleepless nights and anxious 
days over her little one, whose piercing and continual 
cries are occasioned by improper diet. The mother's 
own breasts often furnish the aliment of the mischief 
to her babe, either because acid food or a deranged 
state of her own digestive organs prevents her food 
from being converted into healthy milk. A young in- 
fant rarely cries unless suffering pain. If the mother 
has insufficient nurse for her child, the best substitute 
is fresh cow's milk, diluted with one-third part water, 



101 

boiled and sweetened with a little white sugar. As 
the child grows older, the proportion of water may be 
reduced. When a child is troubled with wind, aro* 
matic seeds, the root of sweet flag, and such like arti- 
cles steeped in boiling water, and fed freely to the child, 
will give relief. The following is a very good combi- 
nation for the same purpose : 

5r Paregoric, 1 

Aromat. Syrup of Rhubarb, 

Elixir Salutis, > equal parts. 

Syrup of Ginger, 

Cinnamon Water, J 

Dose, one teaspoonful diluted with the same quan- 
tity of water. By observing these directions, most cry- 
ing children may become quiet, especially if the mother 
will take a dose of magnesia, or magnesia and rhu- 
barb, herself. 



SURGERY. 



External injuries to the body, resulting from disease, 
accident or design, are, 

Contusions, 
Wounds, 
Fractures, 
Dislocations. 

A CONTUSION 

Is the necessary consequence of every blow, and is 
known by the swelling and discoloration of the skin. 

If slight, bathe the part frequently with cold vinegar 
and water for a few hours, and then rub it well with 
brandy, or spirits of any kind. Should it be very great, 
or so as to have affected the whole body, which may 
be known by a general soreness, bleed and purge the 
patient, and confine him to a diet of rice water, lemon- 
ade, panada, &c. If fever comes on, repeat the bleed- 
ing, purging, &c. In all cases of this nature, be sure 
the water is regularly evacuated, for it sometimes hap- 
pens that in consequence of the nerves of the bladder 
being palsied by the blow, the patient feels no desire to 
pass it, though the bladder be full. If a suppression 
ensues, pass a catheter, if possible, or procure assist- 
ance for that purpose. 

OF SPRAINS. 

Plunge the part sprained into very cold water, and 
hold it there as long at a time as you can bear it — for 
several hours — then rub it well with camphorated spi- 
rits. If the accident has happened to a joint, as in the 
ankle, and it remains weak, pour cold water on it from 
the spout of a teakettle, held at a distance, several times 
in the day. The most serious effect, however, resulting 
from contusion, is when the blow is applied to the 



103 

head, producing either concussion or compression of the 
brain. 

CONCUSSION OF THE BRAIN. 

Symptoms. — The patient is stunned, — his breathing 
slow, — drowsiness, — stupidity, — the pupil of the eye 
rather contracted, — vomiting. After a time he recovers. 

Treatment. — Apply cloths dipped in cold vinegar 
and water to his head, and when the stupor is gone, 
bleed him, and open his bowels with Epsom Salts, 
(No. 8.) He should be confined to bed, kept on a low 
diet, in a quiet situation, and every measure taken to 
prevent an inflammation of the brain, which, if it 
comes on, must be treated by copious bleeding, blis- 
ters, &c. 

COMPRESSION OF THE BRAIN. 

Symptoms. — Loss of sense and motion,— slow, noisy, 
and laborious breathing, — pulse slow and irregular,— 
the muscles relaxed, as in a person just dead, — the pu- 
pil of the eye enlarged, and will not contract, even by 
a strong light, — the patient lies like one in an apoplec- 
tic fit, and cannot be roused. 

Treatment. — Open a vein and draw off sixteen or 
twenty ounces of blood, shave the head, and, if possi- 
ble, procure surgical assistance without delay, as there 
is nothing but an operation that can be of any avail. 

WOUNDS. 

In bad wounds there is often a profuse bleeding 
which requires the first and most particular attention. 
The application of dry lint and a bandage will often 
succeed, but if an artery of any considerable size is in- 
jured, and the blood spurts out largely, you must form 
some tight compression between the wound and the 
trunk of the body or heart, which will stop the dis- 
charge, till you can find the bleeding, and secure it with 
your needle. If it be an arm or a leg that is wounded 
or taken off, take a strong handkerchief or large cord, 
and tie it moderately tight some way above the wound : 
if the injury is below the knee or elbow, it will be best 



104 

to fix the cord two or three inches above the knee or 
elbow, and put a round short piece of wood beneath 
the cord • by turning this stick round, you tighten the 
cord till it stops the blood ; let some one hold the stick 
in this position, till you wipe the blood from the 
wound * then slacken the cord till the blood spurts out, 
at which time fix your eye on the vessel ; order the 
cord again tightened, and keep sight of the vesse], till 
you pass your crooked needle along side of the vessel, 
about a quarter of an inch deep, and draw the thread 
half through ; then enter the needle where it came out, 
and pass it up the other side of the blood-vessel so that 
the point may come out near where you entered it ; 
then draw the thread through, and tie it tight, and it 
will stop the bleeding of that vessel ; proceed in like 
manner for others j then take off the cord, and dress the 
wound with lint, bandage, &c. After the first dressing, 
you had better let the wound go for three or four days 
before opening it, after which it may be dressed every 
day. If the discharge of matter be considerable, put a 
little lint over the wound, and over that a plaster of 
basilicon, but when there is little or no discharge of 
matter, apply simple ointment, or Cerate, (No. 29.) If 
any wound, bruise, or swelling grows painful, turns 
purple, or dark colored, and small blisters arise on or 
near it, of a purple, dark, or yellow color, then there 
is danger of gangrene, to prevent which, let the part 
be scarified or pricked in several places with a lancet, 
and the scars dressed with Basilicon, (No. 30.) It may 
be wet with vinegar ; brine, or sea salt. A cloth wet 
with vinegar, and some Bark, (No. 11,) sprinkled in, 
may be put on it ; also the bark must be given inward- 
ly, as directed in fevers and ague. Swellings ought 
to be poulticed, and when they grow soft, open and 
dress them with basilicon, and continue the poultice 
some time over the salve. 

PUNCTURED WOUNDS. 

These are caused by sharp pointed instruments, as 
needles, awls, nails, &c. Having stopped the bleeding, 
withdraw any foreign body, as part of a needle, splin- 



105 

ters, bits of glass, &c, that may be in it provided it 
can be done easily ; and if enlarging the wound a little 
will enable you to succeed in this, do so. Though it 
is not always necessary to enlarge wounds of this na- 
ture, yet in hot weather, it is a mark of precaution, 
which should never be omitted. As soon as this is 
done, pour a little turpentine into the wound, or touch 
it with caustic, and then cover it with a poultice moist- 
ened with Laudanum, (No. 16.) This practice may 
prevent locked-jaw, which is but too frequent a conse- 
quence of wounds of this description. When matter 
forms, cover the part with mild dressings, as a common 
sore. Laudanum may be given in large doses, to relieve 
pain, and should the inflammation be excessive, bleed 
and purge. In hot weather, however, bleeding should 
be employed in great moderation. 

CONTUSED WOUNDS. 

Wounds of this nature are caused by round or blunt 
bodies, as musket balls, clubs, stones, &c. They are 
in general attended by but little bleeding ; if, however, 
there should be any, it must be stopped. If it arises 
from a ball which can be easily found and withdrawn, 
it is proper to do so, as well as any piece of the 
clothing, &c, that may be in it ; or if the ball can be 
distinctly felt, directly under the skin, make an incision 
across it and take it out, but never allow of any poking 
in the wound to search for such things ; the best ex- 
tractor of them, as well as the first and best application 
in contused wounds, proceed from what they may, being 
a soft bread and milk poultice. Should the inflamma- 
tion be great, bleed and purge. Pain may be relieved 
by laudanum, and if the parts assume a dark look, 
threatening mortification, cover them with a blister. 

If the wound is much torn, wash the parts very nicely 
with warm water, and then (having secured every 
bleeding vessel) lay them all down in as natural a po- 
sition as you can, drawing their edges gently together, 
or as much so as possible, by strips of sticking plaster, 
or stitches, if necessary. A soft poultice is to be ap- 
plied over the whole. 



106 
WOUNDS OF THE LIMBS, &c. 

OF THE EAR, NOSE, &C. 

Wash the parts clean, and draw the edges of the 
wound together by as many stitches as are necessary. 
If the part is even completely separated, and has been 
trodden under foot, by washing it in warm water, and 
placing it accurately in its proper place by the same 
means, it may still adhere. 

OF THE SCALP. 

In all wounds of the scalp it is necessary to shave 
off the hair. When this is done, wash the parts well, 
and draw the edges of the wound together with stick- 
ing plaster. If it has been violently torn up in severaL 
pieces, wash and lay them all down on the skull again, 
drawing their edges as nearly together as possible by 
sticking plaster, or if necessary by stitches. Cover the 
whole with a soft compress smeared with some simple 
ointment, (No. 29.) 

OF THE THROAT. 

Seize and tie up every bleeding vessel you get hold 
of. If the windpipe is cut only partly through, secure 
it with sticking plaster ; if it is completely divided, 
bring its edges together by stitches, taking care to pass 
the needle through the loose membrane that covers the 
windpipe, and not through the windpipe itself. The 
head should be bent on the breast, and secured by bol- 
sters and bandages in that position, to favor the approxi- 
mation of the edges of the wound. 

OF THE BELLY. 

Close the wound by strips of sticking plaster, and 
stitches passed through the skin, about half an inch 
from its edges, and cover the whole with a soft com- 
press, secured by a bandage. Any inflammation that 
may arise is to be reduced by bleeding, purging, and 
a blister over the whole belly. 

Should any part of the bowels come out at the 
wound, if clean and uninjured, return it as quickly as 
possible ; if covered with dirt, clots of blood, &c, wash 



107 

it carefully in warm water previous to so doing. If 
the gut is wounded and only cat partly through, draw 
the two edges of it together hy a stitch, and return it 3 
if completely divided, connect the edges hy four stitches 
at equal distances, and replace it in the helly, always 
leaving the end of the ligature projecting from the ex- 
terna,] wound, which must he closed by sticking plaster. 
In five or six days, if the threads are loose, withdraw 
them gently and carefully. 

OF JOINTS. 

Bring the edges of the wound together by sticking 
plaster without any delay, keep the part perfectly at 
rest, bleed, purge, and live very low, to prevent inflam- 
mation. Should it come on, it must be met at its first 
approach by bleeding to as great an extent as the con- 
dition of the patient will warrant, and by a blister 
covering the whole joint. If a permanent stiffening of 
the joint seems likely to ensue, keep the limb in that 
position which will prove most useful, that is, the leg 
should be extended, and the arm bent at the elbow. 
Wounds of joints are always highly dangerous, and 
frequently terminate in death. 

OF TENDONS. 

Tendons or sinews are frequently wounded and rup- 
tured. They are to be treated precisely like any other 
wound, by keeping their divided parts together. The 
tendon which connects the great muscle, forming the 
calf of the leg, with the heel, called the tendon of 
Achilles, is frequently cut with the adze, and ruptured 
in jumping from flights. This accident is to be reme- 
died by drawing up the heel, extending the foot and 
placing a splint on the fore part of the leg extending 
from the knee to beyond the toes, which being secured in 
that position by a bandage, keeps the foot in the posi- 
tion just mentioned. The hollows under the splint 
must be filled up with tow or cotton. If the skin falls 
into the space between the ends of the tendon, apply 
a piece of sticking plaster, so as to draw it out of the 
way. It takes five or six weeks to unite, but no weight 
should be laid on the limb for several months. 



108 

FRACTURES. 

Fractures are known by the sudden and severe pain, 
■ — by the misshapen appearance of the limb, — some- 
times by its being shortened, — by the patient being un- 
able to move it without excruciating pain, — but most 
certainly^ by grasping the limb above and below the 
spot where the fracture is supposed to exist, and twist- 
ing it different ways, when a grating will be felt, oc- 
casioned by the broken ends of the bone rubbing against 
each other. If the swelling, however, is very great, 
this experiment should not be made until it is reduced. 

OF THE BONES OF THE NOSE. 

The bones of the nose, from their exposed situation, 
are frequently forced in. Any smooth article that will 
pass into the nostril should be immediately introduced 
with one hand, to raise the depressed portions to the 
proper level, while the other is employed in molding 
them into the required shape. If a violent inflamma- 
tion follows, bleed, purge, and live on a low diet. 

OF THE LOWER JAW. 

This accident is easily discovered by looking into the 
mouth, and is to be remedied by keeping the lower jaw 
firmly pressed against the upper one, by means of a 
bandage passed under the chin and over the head. If 
it is broken near the angle, or that part nearest the ear, 
place a cushion or roll of linen in the hollow behind it 
over which the bandage must pass, so as to make it 
push that part of the bone forward. The parts are to 
be confined in this way for twenty days, during which 
time, all the nourishment that is taken should be suck- 
ed between the teeth. If in consequence of the blow, 
a tooth is loosened, do not meddle with it, for if let 
alone it will grow fast again. 

OF THE COLLAR BONE. 

This accident is a very common occurrence, and is 
known at once by passing the finger along it, and by 
the swelling, &c. To reduce it seat the patient in a 
<jhair, without any shirt, and place a pretty stout com- 



109 

press of linen made in the shape of a wedge, under his 
arm, the thick end of which should press against the 
armpit. His arm bent to a right angle at the elbow, is 
now to be brought down to his side, and secured in that 
position by a long bandage, which passes over the arm 
of the affected side and round the body. The forearm 
is to be supported across the breast by a sling. It takes 
from four to five weeks to re -unite. By the forearm is 
meant that part of it which reaches from the elbow to 
the wrist. The arm extends from the shoulder to the 
elbow. 

OF THE ARM. 

Seat the patient on a chair, or the side of a bed, let 
one assistant hold the sound arm, while another grasps 
the wrist of the broken one and steadily extends it in an 
opposite direction, bending the forearm a little to serve 
as a lever. You can now place the bones in their pro- 
per situation. Two splints of shingle or stout paste- 
board, long enough to reach from below the shoulder 
near the elbow, must then be well covered with tow or 
cotton, and laid along each side of the arm and kept in 
that position by a bandage. The fore-arm is to be sup- 
ported in a sling. Two smaller splints may for better 
security be laid between the first ones, that is, one on 
top, and the other' underneath the arm, to be secured by 
the bandage in the same way as the others. 

OF THE BONES OF THE FOREARM. 

These are to be reduced precisely in the same way, 
excepting the mode of keeping the upper portion of it 
steady, which is done by grasping the arm above the 
elbow. When the splints and bandage are applied, 
support it in a sling. 

OF THE WRIST, &C. 

This accident is of rare occurrence. When it does 
happen the injury is generally so great as to require 
amputation. If you think the hand can be saved, lay it 
on a splint well covered with tow ; this extends beyond 
the fingers ; place another splint opposite to it lined 
10 



110 

with the same soft material, and secure them by a ban- 
dage. The hand is to be carried in a sling. 

The bones of the hand are sometimes broken. When 
this is the case, fill the palm with soft compresses or 
tow, and then lay a splint on it long enough to extend 
from the elbow to beyond the ends of the fingers, to be 
secured by a bandage as usual. 

When a finger is broken, extend the end of it until it 
becomes straight, place the fractured portion in its place, 
and then apply two small pasteboard splints, one be- 
low and the other above, to be secured by a narrow 
bandage. The top splint should extend from the end 
of the finger over the back of the hand. It may some- 
times be proper to have two additional splints for the 
sides of the fingers. 

OF THE RIBS. 

When, after a fall or blow, the patient complains of 
a pricking pain in his side, we may suspect a rib is 
broken. It is ascertained by placing the tips of two or 
three fingers on the spot where the pain is, and desiring 
the patient to cough, when the grating sensation will 
be felt. All that is necessary is to pass a broad ban- 
dage round the chest, so tight as to prevent the motion 
of the ribs in breathing, and to observe a low diet. 

OF THE THIGH. 

A grating sensation is felt, the limb is shortened, the 
part is painful and the limb unable to support the weight 
of the body ; when the neck of the bone is fractured, 
the leg is much shorter, and the toes turned inwards. 
The limb must be bent a little towards the body ; one 
assistant is to grasp the limb round the groin and hold 
it steady, while another firmly holds the limb above the 
knee, and gently but firmly extends the thigh : the ends 
of the bones will by these means be reduced or brought 
together. Let the splints be prepared, one of sufficient 
length to reach from the hip joint down to the knee, 
the other on the inside of the thigh to a little below the 
knee. Thick pasteboard cut to a proper taper, is the 
best material for splints, for when dipped in water it 



Ill 

takes the shape of the limb, and when dry remains a 
firm and even support. The splints should he lined 
with tow or other soft material. The best bandage for 
broken limbs is made as follows. Take a strip of mus- 
lin about four inches wide, of sufficient length to reach 
from the upper and inner portion of the thigh to the 
knee, a sufficient number of cross-pieces or tails to 
cover as much of the part as is requisite. Each of the 
cross-pieces is to be proportioned to the circumference 
of the thigh ; the upper tails will be twice the length of 
the lower. After laying the first mentioned strip upon 
a table, fix the upper end of it in some way. Then be- 
gin laying the upper tails across it, and proceed with 
placing the rest ; each tail must be long enough to ex- 
tend about two inches beyond the opposite one when 
they are both applied. The tails being all arranged 
across the single strip, are to be stitched in that posi- 
tion with a needle and thread. Then place the ban- 
dage under the thigh so that the longitudinal band shall 
come directly under the thigh ; each tail should lap a 
little over the next upper one before it is fastened to 
the band. Apply the splints each side of the limb, and 
bring the lower tail first over the thigh, and cover that 
by the next upper one, and in this way proceed upwards 
till all the cross pieces are applied, the uppermost one 
of which should be fastened with a pin. The advan- 
tage of this many-tailed bandage is, that it may be re- 
moved and reapplied without disturbing the limb. Place 
the limb upon a pillow and direct the patient to lie a 
little on the fractured side, with the leg and foot bent 
upon the thigh and supported by a pillow. 

It will add greatly to the comfort of the patient to 
rest his limb upon a double inclined plane, one part 
extending from the hip to the back of the knee, the 
other from that point to beyond the heel. It may be 
made of smoothly planed boards fastened together and 
braced at such an angle that when covered with a pil- 
low or other soft material, the limb will rest comfortably, 
slightly bent. A trough made at the same angle, just 
wide enough for the thigh and leg with the bandage and 
cushion, would be still more comfortable to the patient. 



112 

It is very rare that the sufferer escapes without a short- 
ening of the limb under the best treatment. 

OF THE KNEE-PAN. 

This accident is easily ascertained on inspection. It 
may be broken in any direction, but is most generally 
so across or transversely. It is reduced by bringing the 
fragments together, and keeping them in that position 
by a long bandage passed carefully round the leg, from 
the ankle to the knee, then pressing the upper fragment 
down so as to meet its fellow (the leg being extended), 
and placing a thick compress of linen above it, over 
which the bandage is to be continued. 

The extended limb is now to be laid on a broad splint, 
extending from the buttock to the heel, thickly covered 
with tow to fill up the inequalities of the leg. For ad- 
ditional security, two strips of muslin may be nailed to 
the middle of the splint, one on each side, and passed 
about the joint, the one below, and the other above, so 
as to form a figure of eight. In twenty or thirty days 
the limb should be moved a little to prevent stiffness. 

If the fracture is through its length, bring the parts 
together, place a compress on each side, and keep them 
together with a bandage, leaving the limb extended and 
at rest. Any inflammation in this, or other fracture, is 
to be combated by bleeding, low diet, &c, &c. 

OF THE LEG. 

From the thinness of the parts covering the princi- 
pal bone of the leg, it is easy to ascertain if it is bro- 
ken obliquely. If, however, the fracture be directly 
across, no displacement will occur, but the pain, swell- 
ing, and the grating sensation, will sufficiently decide 
the nature of the accident. 

If the fracture is oblique, let two assistants extend 
the limb, while the broken parts are placed by the hand 
in their natural position. Two splints that reach from 
a little above the knee, to nine or ten inches below the 
foot, having near the upper end of each four holes, and 
a vertical mortice near the lower end, into which is fit- 
ted a cross piece, are now to be applied as follows : 



113 

Lay two pieces of tape, about a foot long, on each side 
of the leg, just below the knee-joint, and secure them 
there by several turns of a bandage ; pass a silk hand- 
kerchief round the ankle, across it on the instep, and 
tie it under the sole of the foot. The two splints are 
now placed one on each side of the leg, the four ends 
of the piece of tape passed through the four holes and 
firmly tied, and the cross-piece laid in the mortice. By 
tying the ends of the handkerchief to this cross-piece 
the business is finished. 

If the fracture is across, and no displacement exists, 
apply two splints of stout pasteboard, reaching from 
the heel to the knee, and well covered with tow, one on 
each side of the leg, securing them by a bandage pass- 
ing round the limb and outside the splints. 

OF THE BONES OF THE FOOT. 

The bone of the heel is sometimes, though rarely, 
broken. Tt is known by a crack at the moment of the 
accident, a difficulty in standing, by the swelling, and 
the grating noise on moving the heel. To reduce it, 
take a long bandage, lay the end of it on the top of the 
foot, carry it over the toes under the sole, and then by 
several turns secure it in that position. 

The foot being extended as much as possible, carry 
the bandage along the back of the leg, above the knee, 
where it is to be secured by several turns, and then 
brought down on the front of the leg, to which it is se- 
cured by circular turns. In this way the broken pieces 
will be kept in contact, and in the course of a month, 
or six weeks, will be united. 

Fractures of the foot, toes, &c, are to be treated like 
those of the hand and ringers. 

DISLOCATIONS. 

Dislocations, or bones being out of joint, are known 
by the deformity of the joint when compared with its 
fellow,— by the pain and inability to move the limb, — 
by its being longer or shorter than usual, and by the 
impossibility of moving it in particular directions. 

Jaw. — If the jaw is out of joint, the operator must 

IQ* 



114 

put linen cloths round his thumbs, then put them in the 
patient's mouth on the joints, and push down the ends 
of the bone at the same time with his fingers under his 
chin, pull a little forwards so as to open the joints, then 
lift it into its own place. Take care that the thumbs 
are not bitten as the jaw goes into its place. 

Neck. — If the neck is out of joint, the operator must 
immediately place his knees against the patient's 
shoulder, and pull his head upwards, so as to bring the 
bone into its place. 

Shoulder. — If the shoulder is out of joint, a rope 
may be stretched on a level, or a board may be set edge 
upwards just so high as the patient can stand up and 
lay his arm over it ; let it come close to his body ; let 
the operator take hold of his arm, and pull it forward, 
and bear down ; let the patient settle downwards at the 
same time, and it will generally go into its place ; or 
the end of a board may be hollowed out like the part 
of a circle, so as to lay to the body under the arm ; then 
the arm lifted and extended ; the arm, hand and wrist 
maybe lashed fast to the board, — and then bear it gent- 
ly down, and it will lift the joint into its place. These 
directions suppose the bone to have fallen below the 
joint, which is generally the case ; but if otherwise, 
that, and almost all other bones out of joint or broken, 
must be set in the common form, by steadying the body 
and pulling at the limb, until it is so far extended as to 
replace the joints or fractures. 

Elbow. — Extension is to be made by assistants pull- 
ing gradually in opposite directions, while the opera- 
tor returns the bones into their proper place. After- 
wards the arm must be bent and suspended for some 
time with a sling about the neck. Proceed in the same 
manner, in case of disjointed wrists or fingers. 

Thigh. — When the thigh bone is out of joint, the pa- 
tient must be laid on his back, and fastened down ; ex- 
tension must be made by means of slings, fixed about 
the bottom of the thigh, a little above the knee. While 
the extension is making, push the head of the bone out- 
ward till it enters the socket. If the dislocation is out- 



115 

ward, lay the person on his face, and during the ex- 
tension, push the head of the hone inward. 

Knee Joint. — Extension is to he made upwards hy 
the thigh, and downwards hy the leg, and the hones 
replaced by pressure with the hand. So likewise for 
the ankle joint. 

OF COMPOUND ACCIDENTS. 

Having spoken of the treatment to he pursued for 
a hruise, wound, fracture and dislocation, as happening 
singly, it remains to state what is to be done when they 
are united. 

We will suppose that a man has been violently 
thrown from a carriage. On examination, a wound is 
found in his thigh bleeding profusely, his ankle is out 
of joint with a wound communicating with its cavity, 
and the leg broken. 

In the first place stop the bleeding from the wound 
in the thigh ; reduce the dislocation next : draw the 
edges of the wounds together with sticking plaster ; 
and procure a surgeon as quickly as possible. 

If, instead of a wound, fracture and dislocation, there 
is a concussion or compression of the brain, a disloca- 
tion and fracture, attend to the concussion first, the dis- 
location next, and the fracture the last. 

RUPTURE, OR BURST. 

When these tumors become painful they must be 
reduced to prevent strangulation, which, without the 
assistance of a skillful surgeon, would prove fatal. 

Directions for the reduction of the tumor. — Place the 
patient on the back, and raise the foot of the bed 
twenty or thirty inches higher than the head. Cover 
the tumor with one or both hands, and press upon it 
uniformly, moderately, but with gradually increasing 
firmness. The power should generally have an upward 
direction : but may be occasionally varied a little from 
right to left. Persist in this effort, if the patient will 
submit to it, for half an hour ; but if it fail of success, 
bleed the patient, while standing erect, even to faint- 
ness, and while in that state renew the effort to reduce 



116 

the tumor as before. Should this prove ineffectual, 
cover the tumor with pounded ice, or with flannel 
dipped in cold water, made still colder by the addition 
of as much salt as it will dissolve ; or, if this process 
fails, or ice or cold water is not at hand, it may be well 
to try the dropping slowly of Ether, (No. 21,) upon the 
part, blowing it with a pair of bellows or the mouth for 
some time. The position of the patient to be as first 
directed. If the reduction be not effected by this course, 
give a clyster of tobacco, made by boiling a piece of 
tobacco of the size of a large walnut in a pint of water. 
Repeat this clyster every thirty minutes, until the 
muscles of the whole system become relaxed; then 
elevate the lower extremities, and make a persevering, 
last effort to reduce the rupture. Apply a truss, to pre- 
vent a second descent. 

LOCK JAW. 

Give opium in large quantities, as two teaspoonsful 
of the tincture, (laudanum,) every half hour. When 
the patient can no longer swallow, inject laudanum, a 
tablespoonful in warm water, every hour, and let it be 
retained as Jong as possible. 

With the first dose of laudanum, give ten grains of 
calomel, and follow it every six hours by a dose of five 
grains, till the mouth is affected. Use warm and cold 
bathing successively. If the disease proceed from a 
wound, enlarge it pretty extensively, and pour into it hot 
spirits of turpentine, or burn the wound with an iron 
brought to a white heat. 

MORTIFICATION. 

From what has already been stated, it is evident, 
that in treating wounds, &c, as well as diseases, one 
great and important indication is to repress excessive 
inflammation, which, if allowed to proceed to a certain 
point, sometimes produces mortification or the death of 
the parts. 

Whenever, therefore, from the violence of the fever, 
heat, pain, redness and swelling, you are fearful of its 
ending in this way, bleed, purge, &c> to as great an 



117 

extent as the patient can bear. If, however, the fever 
and pain suddenly cease, if the part which before was 
red, swollen and hard, becomes purple and soft, abandon 
at once all reducing measures, lay a blister over the 
whole of the parts, and give wine, porter, bark, &c, 
freely, and without delay. If the blisters do not put a 
stop to the disease, and the parts become dead and 
offensive, cover them with the charcoal or fermenting 
poultice until nature separates the dead parts from the 
living, during which process a generous diet, bark, &c, 
must be allowed. 

There is a particular kind of mortification which 
comes of itself, or without any apparent cause. It'* 
attacks the small toes of old people, and commences 
in a small bluish or black spot, which spreads to dif- 
ferent parts of the foot. To remedy it, place a blister 
over the spot, and give two grains of opium, night and 
morning ; taking care to keep the bowels open by castor 
oil, and to diminish the quantity of the opium if it occa 
sions any unpleasant effects. 

In extensive mortifications of the forearm, it. is 
necessary to amputate. This however, should never 
be done, until by the repeated application of blisters to 
the sound parts adjoining the mortified ones, they are 
disposed to separate, which may be easily known by 
inspection. 

CHILBLAINS, OR FROSTED LIMBS. 

Symptoms. — Chilblains are painful, inflammatory 
swellings of a purple or leaden color, to which the 
hands, ears, nose, feet, &c, are subject on being ex- 
posed to severe cold. 

Treatment. — Any part of the body when first frost- 
bitten should be rubbed with snow, then iced or snow 
water, then cold water, gradually adding warmth to the 
part. Should this not be done and the other symptoms 
follow, the diseased parts should be rubbed with stimu- 
lating substances, such as Opodeldoc, (No. 23,) Spirits 
Turpentine, Volatile Liniment, Spirits Camphor, 
(No. 26.) Wheat or rye flour mixed up with 
molasses to form a fermenting poultice, and bound 



118 

upon the limbs, greatly relieves the disease. Should 
ulceration ensue, the sores should be kept clean and 
dressed with Basilicon, (No. 30.) Should the parts be 
so badly frosted as to turn black, they should be poul- 
ticed in the manner mentioned above until the dead 
parts seem to be separating, then apply the ordinary 
poultice of crumbs of bread or Indian meal until they 
heal. 

TO REMOVE MOTES AND FOREIGN PARTICLES 
FROM THE EYE. 

If the substance can be seen upon the eyeball, re- 
move it with a piece of paper rolled up and softened in 
the mouth. If it is out of sight, take hold of the eye- 
lashes with the thumb and finger and then with a large 
needle or other slender article, press upon the center of 
the eyelid and turn it over. The offending substance 
will be seen usually on the eyelid and may be removed 
as mentioned above. Particles of sand or dust may be 
washed out by a syringe or by the assistant's filling his 
mouth with water and spurting it into the eye. 

Blacksmiths, cutlers and other artificers in iron and 
steel are very liable to the lodgment of small sharp parti- 
cles of metal in the eye . They enter with great force the 
coats of the eye, and if suffered to remain produce in- 
flammation, ulceration and very often a loss of the eye. 
If a magnet will not remove the troubler, you must 
take the sharp point of a small penknife or a large 
needle, and with a steady hand dislodge the particle 
from the coats of the eye * considerable force is often 
necessary to effect this. Application of cold water by 
folded linen will generally be necessary to subdue the 
consequent inflammation. 

Inflammation of the eyelids will occasion a sensation 
like dirk in the eye and may be detected upon turning 
up the lid by the plush-like appearance of the lining 
membrane. 

SORE EYES, 

When first inflamed, may be frequently bathed in 
cold water, or equal parts of spirit and water \ cloths 



119 

dipped in either may be laid on, especially on going to 
bed at night. A dose of Salts, (No. 8,) or of Cream of 
Tartar, (No. 10,) should be given every other night. 
After two or three days of such treatment, make use of 
the eye-water. (See Recipes.) 

BURNS AND SCALDS. 

Dissolve as much Alum, (No. 43,) as the water will 
take up, dip linen or cotton rags in it, and lay upon the 
burn, and repeat it as the cloths get dry. Equal parts 
of linseed oil and alum water, or lime water with cotton 
is a good dressing. This may be followed, after a few 
days, by basilicon spread upon linen or cotton cloth. 
It is generally best not to remove the skin from a burn. 
If the burn is so severe as to take off the skin, the 
spirits of turpentine may be put upon cotton and 
applied. The spirits of turpentine, if too severe, may 
be mixed with as much linseed oil. Should there be 
chills, twenty drops of laudanum, and a glass of wine, 
should be administered, and repeated, if the chills con- 
tinue, to support the system. When the healing is well 
commenced, you may dress the ulcers with Turner's 
Cerate, (No. 29.) 

FELONS. 

A felon is an inflammation that occurs at the end of 
the fingers or toes, and is exceedingly painful and very 
much disposed to form matter. There are several kinds, 
varying chiefly in the depth to which the inflammation 
extends. In the deeper seated forms the pain is very 
distressing, extending up the limb and preventing sleep. 
Sometimes there will be little swelling of the affected 
finger, but a great deal in the hand and about the 
wrist. 

Treatment. — With a lancet or penknife cut down at 
one stroke to the bone, lengthwise of the finger or toe 
affected, as soon as the disease is evident. Avoid 
cutting the arteries which are upon each side of the 
fingers and toes. Apply a flaxseed poultice, or of any 
other softening article. This course will give imme- 
diate relief and save the bones. 



120 

CASES WHICH MOST STRONGLY REQUIRE 
BLEEDING 

Are violent falls or bruises, especially when the head 
or breast is much affected ; in pleurisy fever likewise. 
Bleeding is oftentimes advantageous in other inflam- 
matory fevers. As the loss of blood has a very debili- 
tating effect, it ought to be avoided in all cases attended 
with much weakness. In bleeding tie a garter moder- 
ately tight round the arm, two inches above the elbow ; 
after the veins have filled it is generally best to 
open the one that appears the largest. The arteries, 
which are known by their pulsation, lie below some of 
the veins, and ought to be carefully avoided. If you 
feel carefully in the bend of the arm, nearest to the 
under side, you can discover the beating, and will 
endeavor of course not to open a vein directly over it. 
After bleeding, put a little lint on the opening, and 
bind it up with any soft bandage. 

Note. — Bleeding should not be resorted to imme- 
diately after a fall, while the pulse is feeble, and the 
countenance pale, but some hours after, when the 
system recovers from the shock, and the pulse rises. 

AMPUTATION. 

It is not very frequently necessary to amputate a 
limb on board of ship, but as such cases have occurred, 
particularly on whaling voyages, I venture to give 
some directions for the operation. 

. When a limb is crushed, the arteries and other soft 
parts lacerated, or a fracture of tbe bones with a lacera- 
tion of the flesh by the bone coming through, amputa- 
tion, in most cases, is imperiously demanded. Yet I 
have known some cases of fracture and laceration most 
happily treated by ship-masters without amputation. 
But should mortification threaten, there is no alterna- 
tive. 

Operation. — Having fixed on the part where the 
operation is to be performed, let the operator take a 
piece of paper of sufficient length to encircle the limb, 
and four or fiy^ inches in width, and apply it around 
the limb so as to obtain the exact measure, and all the 



*21 

superfluous length should be cut off. It should then be 
folded, and the ends of the paper laid together upon the 
table, and a semicircular arc drawn with a pair of 
dividers by placing one leg of the dividers upon the 
middle of the lower side of the paper. The paper cut 
offupon this line will form two equal semicircles meet- 
ing at angles. Apply the paper, thus cut, again to the 
limb, and mark with ink or crayon the two semicircles 
for the flaps. 

If the thigh is to be amputated, the angles should in 
general be on the inner and outer sides ; if the leg, one 
angle should be in front, the other on the back part of 
the leg ) if the forearm, the angles should be formed 
one over one bone, the other over the other bone, that 
is, on the inner and outer edges, as the hand is pre- 
sented with the palm upward, on account of covering 
the bones handsomely with the flaps. In amputating 
above the elbow, the angles and flaps may be adapted 
to the circumstances of the case or to the convenience 
of the operator, who will always find it most conve- 
nient to stand so as to have his left hand towards the 
upper part of the limb. Having everything in readiness, 
fold or twist up a pocket handkerchief and tie it loosely 
above tbe knee or elbow of the limb to be amputated ; 
pass under it a strong stick or other convenient article, 
about ten or twelve inches long, to twist it up sufficient- 
ly to compress the artery and prevent its bleeding, then, 
whilst an assistant draws up the skin so as to straight- 
en it moderately, the operator fixes his knife on the side 
farthest from him at the angle where the two semicir- 
cular lines meet ; with the edge of the knife, turned 
obliquely upward, he cuts in the direction of the line 
through the skin, fatty substance, and red flesh or mus- 
cles, down to the bone, with repeated strokes. Thus 
having divided one-half of the soft parts of the limb he 
passes his hand above the limb, fixes the point of his 
knife on the angle where he began and follows the line 
upon the upper side of the limb till it meets his first 
incision. He will then have two semicircular flaps 
composed of all the soft parts connected by their natu- 
ral adhesions ; these are to be turned back by a re- 
11 



122 

tractor made by slitting a piece of muslin so that the 
bone will pass into the slit and the flaps can be drawn 
up as far as circumstances will permit. The bone 
should be sawed off as high up as possible. If the arte- 
ries are seen they should be drawn out with a hook, or 
forceps, and tied with a strong silk or linen waxed 
thread. A surgeon's knot is formed by passing the 
thread over the loop the second time before tying. It 
will be best then to pass it over again as in the ordi- 
nary "hard knot.' 5 If the arteries are not seen, the as- 
sistant must slacken the handkerchief a very little, 
when the blood will spurt and show their position. 
After the arteries are secured, the flaps are to be brought 
together as exactly as possible, and secured by strips 
of adhesive plaster from half an inch to an inch in 
width, according to the size of the limb, and sustained 
by compresses of lint and bandages around the limb. 
If the forearm or the leg be amputated, the flesh be- 
tween the bones should be carefully separated, and the 
retractor must be made with two slits. If the flaps are 
marked out by the paper as above described, they will 
come together with mathematical exactness, whatever 
the size of the limb. The fingers and toes may be am- 
putated in the same manner. The ligatures upon the 
arteries should be left long enough to come out at the 
angles of the incision beyond the dressings, and be tied 
sufficiently hard to cut the inner coat of the artery. If 
possible, the dressings should never be removed before 
the fourth day, not reckoning that on which the ope- 
ration is performed. Even when the dressings are to 
be taken away, it will frequently be found useful not 
to remove one strip of plaster, but the stump must be 
made clean, and any discharge present washed away. 
In the course of eight days it may be proper, by very 
gentle force applied to the ligatures, to ascertain whe- 
ther they are loose. As a general rule, the longer the 
stump is left the more useful will it be to the patient. 
The handkerchief ought to be left upon the limb for 
several days, and the stick at hand so as to be ready 
for unexpected hemorrhage. 



123 

OF PERSONS APPARENTLY DROWNED. 

When a person has remained more than twenty min- 
utes under water, the prospect of his recovery is small. 
We should not too soon resign the unhappy object to 
his fate, hut try every method for his relief, as there 
are many well attested instances of the recovery of per- 
sons to life and health, who have been taken out of the 
water apparently dead, and remained so a considerable 
time. In attempting to recover persons apparently 
drowned, the principal intention to be pursued is, to 
restore natural warmth, upon which all the vital func- 
tions depend, and to excite these functions by the appli- 
cation of stimulants. First strip him of his wet clothes, 
and dry him weir; when he is dried, lay him between 
two or three hot blankets, and renew them as they grow 
cold. Rub the patient with warm ashes, or coarse dry 
cloths, and rub on his wrists and ankles Spirits of 
Hartshorn, (No. 17;) and frequently apply the same to 
his nose. You may likewise apply bottles or bladders 
filled with hot water to his feet and armpits. While 
these external means of restoring heat to the body are 
going on, you must innate the lungs as soon as possible 
with a pair of bellows, by inserting the pipe into one 
nostril, while the other nostril and mouth are kept 
closed, and blowing forcibly ; or for want of bellows, 
you may use a common glyster pipe, or in case of ne- 
cessity, a common tobacco pipe or quill. Some person 
should blow through the pipe into one nostril, while 
the other and the mouth are closed as before. When 
the lungs are full, press upon the breast, and force the 
air out again, and then blow as before. Repeat this 
process for half an hour more. In addition to this me- 
thod, you may dip a blanket into boiling water, wring 
it as dry as possible, and wrap the person in it. Re- 
peat this every 15 or 20 minutes for two hours or more. 
These means ought to be continued for two or three 
hours at least, even if no signs of life appear. When 
signs of returning life are apparent, the frictions must 
be continued, but more gently : when the patient can 
swallow, he must take some warm spirits ; when he is 
pretty well recovered, put him into bed, in blankets, 



124 

and give some warm spirits ; if his feet should be cold, 
wrap them up in warm flannels. Never roll a drowned 
person upon a cask. What little life the patient may 
have left will be wholly extinguished by such means. 

DIRECTIONS FOE PASSING CATHETERS. 

Take the penis of the patient near its head between 
the finger and thumb of your left hand (standing beside 
him,) while with your right you introduce the point of 
the instrument into the urinary passage, its convex side 
towards the knees ; while you push the catheter down 
the urethra, endeavor at the same time to draw up the 
penis on it. When you first introduce it, the handle 
will of course be near the belly of the patient, and as 
it descends will be thrown farther from it, until it enters 
the bladder, which will be known by the flow of the 
urine. If you cannot succeed while the patient is on 
his back, make him stand up, or place him with his 
shoulders and back on the ground, while his thighs and 
legs are held up by assistants. If still foiled, place 
him again on his back, and when you have got the 
catheter as far down as it will go, introduce the fore- 
finger, well oiled, into the fundament, and endeavor to 
push its point upward, while you still press it forward 
with the other hand. Force is never, on any account, 
to be used. Vary your position as often as you please ; 
let the patient try it himself, but always remember it is 
by humoring the instrument, and not by violence, that 
you can succeed. 

DIRECTIONS FOR PASSING BOUGIES. 

Take the penis between your finger and thumb, and 
pass the point of the instrument (which should be well 
oiled) down the urethra as directed for the catheter; 
when it has entered three or four inches, depress the 
penis a little, and by humoring the bougie with one 
hand and the penis with the other, endeavor to pass it 
as far as may be wished. The patient himself will 
frequently succeed, when every one else fails. 



125 

APPLICATION OF LEECHES. 

The part must be washed with fair water, and if the 
clothes or bandages have the odor of spirits, or other 
strong smelling articles, they must be removed. Let 
the leeches be put into a glass with a little warm water 
for a few moments, then empty out the water and in- 
vert the glass upon the part to be leeched. If they do 
not bite after a little delay, slightly puncture, with a 
lancet or any other sharp instrument, the skin where 
the leeches are to be applied, and try them again. 
When they have filled themselves they will drop off. 
Bathe the wounds with warm water, or apply a warm 
poultice to promote the bleeding. 

OF FISTULA. 

Symptoms.— An abscess or ulcer in the neighborhood 
of the fundament, preceded by an inflamed hard swell- 
ing, which gives much pain. If there is no communi- 
cation between the gut and the sore, it is called incom- 
plete, if there is, a complete fistula. 

Treatment. — As the tumor is often taken for piles, 
attention should be paid to distinguish them. In all 
cases apply twelve leeches to the part, keep the bowels 
perfectly loose by a diet of rye or Indian mush, and 
confine the patient to his bed. If, however, the forma- 
tion of matter cannot be hindered, the swelling must be 
opened early, and a poultice applied to it, when the dis- 
ease occasionally heals like any other sore, but nine 
times out of ten it forms a callous winding abscess, 
through which (if it is complete) excrements, &c. often 
pass. When it arrives at this point, nothing but an 
operation can ever be of any service. 

There is another species of fistulous opening, which 
follows the obstruction, caused by strictures, &c. in the 
urinary passage. The water not being able to flow 
through the natural canal, makes its way out between 
the bag and the fundament, constituting what is called 
fistula in perineo. It may almost be called an incura- 
ble disease ; at all events, none but a surgeon can do 
anything to relieve it. 
11* 



126 

CORNS AND BUNIONS 

Are formed by successive layers of the hardened 
scarf-skin, usually commencing in a mere point. As 
successive layers are added to the first, the pressure of 
the boot or shoe forces down the hardened and horny 
point upon the inner or true skin. This membrane 
being exceedingly sensitive becomes much irritated and 
painful. Those corns which are formed between the 
toes seem to vary somewhat in their structure, but re- 
quire the same treatment as the others. 

Bunions affect, chiefly, the large joint of the large 
toes, and seem to consist, under the general hardened 
covering, of many small indurated points. 

Treatment. — Shave off the outside layer until you 
can perceive the hardened center, then with a sharp 
pointed knife carefully raise one layer after another 
until you reach the true skin. This, with care, may 
be done without drawing blood. When the corns are 
very tender, it may be necessary to remove portions, at 
intervals of two or three days, until the whole is re- 
moved. It may then be covered with a small adhesive 
plaster. 



OF SWALLOWING POISON. 



GENERAL SYMPTOMS OF POISONING. 

A person may be supposed to be poisoned, if, being 
in perfect health, he be attacked, after having taken 
some food or drink, with violent pain, cramp in the 
stomach, nausea, vomiting, convulsive actions, and a 
sense of suffocation ; or, if he be seized with giddiness,, 
delirium, or unusual drowsiness. 

The effects of poisoning may, in most cases, be 
known and distinguished from natural diseases, or sud- 
den illness, by the following symptoms : 

1. — The person, when in a state of perfect health, 
becomes all at once very ill, sick, with violent pain in 
the stomach, burning in the throat, and retching. In 
sudden apoplexy, the stomach, and throat are not af- 
fected. In cholera and internal inflammations, there 
is no burning in the throat before vomiting begins. 
There is also a feverishness not observed at first in 
poisoning. 

2. — The effects of a strong dose of poison usually 
show themselves in a few minutes, though others, not 
for some hours. After a meal, or eating, when a per- 
son is taken very ill, poisoning may be suspected. 

Apoplexy, cholera, and inflammation, which also 
appear suddenly after eating, may be distinguished as- 
above. 

3. — The effects of poisoning not only appear sud- 
denly, but increase rapidly and alarmingly, after or 
within an hour, and sometimes prove fatal in a few 
minutes. 

Internal inflammation, diseases of the heart, cholera,, 
plague, apoplexy, and some other diseases, that often 
end fatally within a few hours, may be distinguished 
from poisoning, by what is said above, as well as from 
individual circumstances. 



128 

4. — The effects of poisoning most usually increase 
without intermission of their severity, and are also, for 
the most part, uniform in kind. 

Internal inflammations, and some of the diseases al- 
ready mentioned, have often the same character, and 
can only be distinguished by circumstances. Should 
epidemic cholera be prevalent, very great caution will 
be necessary, as its attacks very closely resemble symp- 
toms of irritant poisoning, particularly that by arsenic. 

WHAT TO DO IN GENERAL. 

When it is strongly suspected, from the above symp- 
toms, that poison has got into the stomach, though it 
be not known what sort of poison, not a moment is to 
be lost in removing it, by means of the stomach-pump, 
if one be at hand, and if not, by promoting full and 
copious vomiting. For this purpose, the most speedy 
are, the tickling of the back part of the mouth with a 
feather, and repeatedly thrusting the finger as far back 
into the throat as possible. When the gullet is much 
inflamed, however, none of these means can be em- 
ployed. Other means to be used are given in this 
work. 

ACIDS. 

Oil of Vitriol, — Aquafortis, — Spirit of Sea Salt, — Ox- 
alic Acid. 

Symptoms. — A burning heat in the mouth, throat and 
stomach. — stinking breath,— an inclination to vomit, 
or vomiting of various matters mixed with blood, — 
hiccups, — costiveness or stools more or less bloody, — 
pain in the belly, so great that the weight of a sheet 
cannot be borne, — burning thirst, — difficulty of breath- 
ing, — suppression of urine, &c. 

Remedies. — Mix an ounce of calcined magnesia with 
a pint of water, and give a glassful every two minutes. 
If it is not on hand, use flaxseed tea, rice water, or wa- 
ter alone in large quantities, until the former can be 
procured. If it cannot be obtained, dissolve an ounce 
of soap in a pint of water, and take a glassful every 
two minutes ; chalk or whiting may also be taken by 



129 

the mouth, and clysters of milk be frequently injected. 
If the patient will not vomit, put him in the warm 
bath, bleed him freely, and apply leeches and blisters 
over the parts pained. If the cramps and convulsions 
continue, give him a cup of common tea, with an ounce 
of sugar, half a teaspoonful of Ether, (No. 21,) and 
fifteen or twenty drops of laudanum, every quarter of 
an hour. No nourishment but sweetened rice water is 
to be taken for several days. In these cases never give 
tartar emetic, ipecacuanha, or tickle the throat with a 
feather ; they only increase the evil. 

ALKALIES. 

Caustic Potash, — Caustic Soda, — Hartshorn. 

Symptoms. — These substances occasion the same 
.effects as acids, producing dreadful convulsions. 

Remedies. — Take two tablespoonsful of vinegar or 
lime juice in a glass of water at once, follow it up by 
drinking large quantities of sugar and water. Pursue 
the same treatment as in poisons from acids. 

MERCURY. 

Corrosive Sublimate, — Red Precipitate, — Vermilion. 

Symptoms. — Constriction and great pain in the throat, 
stomach and bowels, — vomiting of various matters 
mixed with blood, — unquenchable thirst, — difficulty of 
urine, — convulsions . 

Remedies. — Mix the whites of a dozen or fifteen eggs 
with two pints of cold water, and give a glassful every 
two minutes, with as much milk as can be swallowed, 
and large doses of ipecacuanha. If after the e^g mix- 
ture is all taken, the vomiting does not stop, repeat the 
dose, with the addition of more water. Leeches, the 
warm bath, blisters, &c, are to be used to reduce the 
pain and inflammation, as before directed. 

ARSENIC. 

Symptoms. — These are the same as produced by the 
mercurial poisons. 

Remedies. — Give large quantities of cold sugar and 
water, until a plentiful vomiting is induced, to assist 



130 

which ipecacuanha* may he taken in considerable 
doses at the same time ;f barley, rice water, flaxseed 
tea, milk, &c, should afterwards be employed. Oil is 
never to be used in this case until the symptoms have 
considerably abated, or the poison has been ejected. 

COPPER. 

The symptoms occasioned by swallowing verdigris 
are nearly the same as those of the mercurial poisons. 
The great remedy is large quanties of sweetened water. 
In addition to this, use all the means recommended for 
corrosive sublimate, &c. 

ANTIMONY. 

Antimonial Wine, — Tartar Emetic, — Butter of Anti- 
mony, &c. 

Symptoms. — Excessive vomiting, — pain and cramp 
in the stomach, — convulsions, &c. 

Remedies. — Encourage the vomiting by sugar and 
water, and if after a while it does not stop, give a grain 
of opium in a glass of the sweetened water, every fif- 
teen minutes. To relieve the pain, apply leeches to 
the stomach, throat, or parts affected. 

LUNAR CAUSTIC. 

Dissolve two tablespoonsful of common table salt, 
in two pints of water • a few glasses of this will in- 
duce vomiting. If not relieved, drink flaxseed tea, 
apply leeches, &c, as for acids. 

SALT-PETRE. 

Pursue the plan recommended for arsenic, omitting 
the lime water. 

LEAD. 

Sugar of Lead, — Extract of Saturn, — White Lead, — 
Litharge, — Minium . 

* To render it more active, ten grains of sulphate of 
zinc may be added to it. 

f Equal parts of lime water and sugared water may 
also be used. 



131 

Symptoms. — A sweet astringent taste in the mouth, — 
constriction of the throat, — pain in the stomach, — 
bloody vomiting, &c. 

Remedies. — Dissolve a handful of Epsom or Glauber 
salts in a pint of water, and give it at once ; when it 
has vomited him, use sweetened water. If the symp- 
toms continue, act as directed for acids. 

OPIUM or LAUDANUM. 

Symptoms. — Stupor, — an insurmountable inclination 
to sleep, — delirium, — convulsions, &c. 

Remedies. — Endeavor to excite vomiting by six 
grains of tartar emetic, or four grains of blue, or thirty 
of white vitriol. Thrust a feather down the throat for 
the same purpose. Never give vinegar or other acids, 
until the poison is altogether or nearly evacuated. 
After this has taken place, a wine-glassful of lemon 
juice and water may be taken every five minutes, along 
with a cup of very strong coffee. The coffee, &c, are 
to be continued until the drowsiness is gone off, which, 
if it continues, and resembles that of apoplexy, must be 
relieved by bleeding. Cold water or ice water should 
be constantly applied to the head. The patient is to 
be forcibly kept in constant motion, or in pain, by 
beating with a light slipper or a small rod, until the 
laudanum has lost its power. 

POISONOUS FISH. 

Remedies. — An emetic. If it has been eaten some 
time, give castor oil by the mouth and clyster. After 
these have operated, twenty drops of ether may be 
taken on a lump of sugar ; vinegar and water as be- 
fore mentioned. 



GONORRHCEA OR CLAP. 



Symptoms. — From two to six days, and sometimes 
two weeks, from an impure connection, an uneasiness 
is felt about the parts of generation, such as an itching 
in the glans or head of the penis, and a soreness and 
tingling sensation along the whole course of the urethra 
or urinary passage. Soon after, the patient perceives 
an appearance 01 whitish matter at its orifice and some 
degree of pungency upon making water* 

In the course of a few days the discharge of matter 
will increase considerably } will assume most probably 
a greenish or yellowish hue, and will become thinner* 
and lose its adhesiveness ; the parts will also be occu* 
pied with some degree of redness and inflammation in 
consequence of which the glans will put on the appear* 
ance of a ripe cherry, the stream of urine will be smaller 
than usual, owing to the canal being made narrower 
by the inflamed state of its lining membrane, and a con* 
siderable degree of pain and scalding heat will be ex- 
perienced on every attempt to make water. 

In consequence of the inflammation, it sometimes 
happens that at the time of passing water there is a 
slight flow of blood also, owing to the rupture of some 
blood-vessel. 

Treatment.— There is no one medicine or combina- 
tion of medicines that will cure every case of clap. 
Some patients are exceedingly difficult of cure by all 
the remedies known. It is not to be expected that 
every kind of medicine is to be found in a family or 
ship's medicine chest. It will be perceived that some 
of the articles mentioned below are not in the numbered 
list at the commencement of this work. The most effi- 
cacious treatment of this disease, if commenced within 



133 

•thirty-six or forty-eight hours of its attack, is as fol- 
lows. Dissolve sixteen grains of lunar caustic in four 
ounces or half a tumbler of cold rain or river water, 
and inject with a glass syringe three or four times a day 
for two days, then dissolve a drachm or a teaspoonful 
of sugar of lead in a pint of pure water which may he 
used with a pew T ter syringe. This is a severe remedy, 
but it saves time and exposure to strictures. The injec- 
tion must not be allowed to enter the penis to a greater 
extent than an inch and a half or two inches. Should the 
discharge under its use become reddish, so much the better. 
An increase of the w T hite discharge must also be expected 
at the first. The bowels must be kept open by salts or 
cream of tartar. After 48 hours have elapsed from the 
attack, it will be unsafe to enter on this mode of treat- 
ment. Then let the patient take a full dose of Epsom 
Salts, (No. 8,) or Cream of Tartar? (No. 10.) Abstain 
from all fermented and spirituous liquors, all animal 
food, mustard, pepper and other stimulating substances. 
Keep as quiet both in body and mind as circumstances 
will permit. Let the penis be covered with a linen or 
muslin rag dipped in a solution of Sugar of Lead, (No. 
42,) an even teaspoonful to a pint of water. Mix equal 
parts of Balsam Copaiva, (No. 24,) and Spirits of Nitre, 
(No. 20,) and about one eighth part of Laudanum, (No. 
16,) give one teaspoonful of water or molasses three 
times a day, keep the bowels open with salts or cream 
of tartar at least as often as every other day. Let the 
patient drink freely of flaxseed tea or a solution of gum 
arabic. One of the most successful remedies in the 
author's own experience, either for recent cases, or for 
those of long standing, is sulphur and cream of tartar 
each two large teaspoonsful, Powdered Nitre, (No. 50,) 
one large spoonful ; mix. Dose, one teaspoonful in 
water thrice a day. The addition of a teaspoonful of 
powdered cubebs to each dose, if they can be procured, 
renders the mixture much more efficacious. The infu* 
sion of uva ursi, &c, as described in the Secondary 
List, is an excellent addition to any of the remedies for 
gonorrhea. Injections of sugar of lead, and of white 
vitriol, and other irritating articles, except within th<e 
12 



134 } 

first twenty-four hours, should not be used until the 
disease has continued at least two weeks, lest they oc- 
casion the swelling of the testicles. 

It frequently happens in the clap, as also in the 
venereal disease, or pox, that there is much inflamma- 
tion, and sometimes the foreskin is so inflamed and 
swollen that it will not pass back, and it also some- 
times gets drawn back and so inflamed and swollen 
that it will not pass forward. If under such circum- 
stances the inflammation is high, bleed the patient to 
the extent of a pint or more, purge him thoroughly 
with salts, apply cold poultices, or cold washes, and let 
him take an even teaspoonful of Salt Petre, (No. 50,) 
in a tumbler of flaxseed tea, three times a day. This 
being done, occasional attempts should be made to bring 
the skin over to its proper place. If it is drawn back 
behind the head of the penis, the penis should be taken . 
between the first and second fingers of each hand, and 
gentle pressure made by both thumbs for a few moments 
upon the head of the penis while the skin is drawn up 
at the same time by the fingers. Gradually the fluids 
will be pressed out of the head, the swelling lessened, 
and the foreskin will come back to its place. If all 
these means fail, the skin should be slit with a sharp 
instrument, so as to bring it to its proper place, and the 
wound poulticed for two or three days, and afterwards 
washed with Lint, (No. 35,) and the Ointment, (No. 29.) 

CHOHDEE. 

When the inflammation of gonorrhoea prevails in a 
very high degree, it prevents the extension of the 
urethra during an erection, so that the penis is, at that 
time, curved downwards, with great pain. The pain is 
much increased if an attempt is made to raise the penis 
towards the belly, and the stimulus occasions it often 
to be erected, particularly when the patient is warm in 
bed, and so deprives him of sleep. 

Treatment. — If this symptom arise during the in- 
flammatory stage, bleeding from the arm is often of 
service, but if five or six leeches can be applied along 
the under surface of the penis ? and allowed to bleed 



J35 

freely, the relief is much greater. Relief may often be 
obtained by exposing the penis to the steam of hot 
water. Cold water also is equally useful. 

Poultices, containing Spirits Camphor, are a good 
application. The patient may take twenty-five to 
thirty drops of laudanum, and a teaspoonful of spirits 
camphor in water. This on going to bed will generally 
prevent an attack. When the chordee continues after 
the inflammation has subsided, the under surface should 
be freely rubbed twice a day with Mercurial Ointment, 
(No. 31.) Chordee is often longer going off than any 
other consequence of gonorrhoea. 

SWELLED TESTICLES, 

Are a very common symptom attending a gonorrhoea. 
The inflammation probably arises from its sympathizing 
with the urethra. The swelling of the testicle coming 
on either removes the pain in making water, and sus- 
pends the discharge, which does not return until the 
swelling begins to subside ; or else the irritation of the 
urethra, first ceasing, produces a swelling of the testi- 
cle, which continues till the pain and discharge return, 
thus rendering it doubtful which is the cause and which 
the effect. 

Treatment. — Rest is the best remedy, and the hori- 
zontal position of the body is easiest. At all events 
the testicles must be well suspended. Treat the case 
as inflammation in general, by bleeding, purging with 
Epsom Salts, applying cloths wrung out in hot water, 
and by poultices. Apply from six to twelve leeches 
if they can be procured, and a poultice after they fall 
off. Sometimes a single vomit of Tartar Emetic, (No. 
1,) will effect a surprising change for the better. If 
these means fail, rub the whole bag with Mercurial 
Ointment. (No. 31.) This may be done also occasion- 
ally if hardness remains after the inflammation has sub- 
sided. If the patient suffers much pain, thirty to forty 
drops of Laudanum should be administered. 

In all cases of venereal disease, the greatest regard 
should be paid to cleanliness. The penis should be 
washed several times a day in water. 



136 

GLEET. 

By the term gleet is meant 'a continued running or 
discharge after the inflammatory symptoms of a clap, for 
some time, have ceased. It is unattended with pain, 
or scalding in making water, &c. The use of Balsam 
Copaiva, steadily persevered in three times a day in the 
dose of thirty to forty drops, using at the same time 
the tonic solution mentioned under Recipes, (p. 30,) will 
relieve many cases. Injections of Sugar of Lead or 
White Vitriol, as aforementioned, are here appropriate 
remedies, and must be persevered in. 

The mixture of Sulphur, Cream of Tartar, Saltpetre 
and Cubebs, as directed for the clap, will be found of 
great service. The uva ursi, as directed in the descrip- 
tion of that article in the first part of this book, by it- 
self or in connection with this mixture, is a superior 
remedy. Cold bathing is useful aso. If these means 
fail, take a middling sized bougie, oil it well with Bal- 
sam Copaiva, and pass it up the passage twice a day. 
Gleet is a most troublesome disease to get rid of, and 
requires great care and perseverance. 

STRICTURE. 

A stricture of the urinary passage does not always 
arise from venereal diseases. Going out of a warm 
into a cold situation, drinking, and other kinds of in- 
temperance, will often bring on an irritable state of the 
canal attended with a spasmodic action of the strictured 
part, an increased difficulty of voiding urine, and even 
a total stoppage of the fluid. The patient makes re- 
peated efforts to relieve himself, but hardly a drop of 
urine is discharged. In the meanwhile the bladder be- 
comes filled and ascends above the bones in front of 
the belly, becomes hard and painful, fever comes on ; 
the countenance looks red, the brain becomes affected, 
and circumstances assume an extremely urgent appear- 
ance. 

Treatment. — Bleed the patient immediately if no- 
thing in his constitution or age forbid. It may even be 
proper to repeat the operation. He should be put into 



137 

a warm bath, and cloths wrung out in hot water laid 
upon the lower part of the bowels and continually re- 
peated. From half a teaspoonful to a teaspoonful of 
Spirits Nitre, (No. 20,) should be taken once in two 
hours, and hot Cream of Tartar beverage pretty freely. 
If leeches can be procured, six or eight should be ap- 
plied between the bag and the fundament. Great bene- 
fit can be derived from fifty to sixty drops of Laudanum, 
(No. 16,) together with an anodyne injection (see page 
31,) containing one teaspoonful of Laudanum. 

When such measures fail in enabling the patient to 
empty his bladder, and the bladder becomes more and 
more distended, an immediate attempt should be made 
to introduce a small flexible elastic gum catheter, 
through the stricture or strictures into the bladder, 
which may be frequently accomplished when due care, 
perseverance and gentleness are not neglected. 

Sometimes when a small catheter cannot be intro- 
duced a very fine bougie may be, and being withdrawn 
from the bladder, the urine follows and is discharged. 
For directions how to introduce these instruments, see 
p. 124. 

When all these remedies prove unavailing, and the 
danger arising from retention of urine continues to 
increase, the only remaining resource is to puncture the 
bladder. The patient must die if the urine is not dis- 
charged. Possibly he may live, even if the operation 
is performed by an unscientific hand. It seems to me 
justifiable, if no professional aid can be obtained, in 
this extreme case, for a friend to puncture the bladder 
with a lancet, a pen-knife, or any other instrument. 
The instrument used may be pushed obliquely down- 
wards and backwards one inch above the bone, on the 
lower part of the belly, and an oiled catheter being all 
ready, it must be immediately introduced through the 
wound and allowed to remain. It should be withdrawn 
once in two days to cleanse it. The other remedies 
may then be continued with more hope of success. 
When the urine passes naturally, the catheter must 
be removed from the wound, and the wound allowed to 
heal. 

12* 



138 

SYPHILIS, OR VENEREAL DISEASE. 

Symptoms.— This disease, known more commonly 
by the name of pox, makes it appearance from three 
days to six weeks, after exposure, in the form of 
chancre, more commonly upon the head of the penis, 
foreskin, or the fraenum or bridle, sometimes on the 
body of the penis, and sometimes on the forepart of the 
bag. It always commences with a chancre. A chan- 
cre begins with an itching in the part. When the inflam- 
mation is upon the head of the penis, a small pimple 
full of matter generally arises without much hardness 
or seeming inflammation, and with very little swelling* 
When chancres occur on the fraenum, or particularly 
upon the foreskin, much more inflammation soon fol- 
lows, attended with effects more extensive and visible. 
The itching is gradually converted into pain. In some 
cases the surface of the foreskin is excoriated and 
afterwards ulcerates; while in other cases a small 
pimple or abscess appears as on the glans or head, and 
then turns into an ulcer. 

When the chancre makes its appearance upon the 
skin of the body of the penis, it is in the form of a 
pimple which commonly forms a scab in consequence 
of evaporation. The first scab is generally rubbed off, 
after which a second still larger is produced. A con* 
siderable inflammation of the glans and foreskin often 
follows with much swelling, preventing the foreskin 
from being drawn back, as described under the head of 
gonorrhoea. A chancre or venereal ulcer appears exca* 
vated, has a thickened base, and is foul with matter. 

Treatment. — Let the pimples or chancres be tho- 
roughly cauterized either with Blue Vitriol, (No. 40,) or 
by lunar caustic, and the burning be repeated once or 
twice. A full dose of salts should be taken in the next, 
place. After their operation take from twelve to fifteen 
drops of Mercurial Solution, (No. 19,) in half a tumbler 
of sweetened water twice a day, or a Mercurial pill, 
(No. 7,) morning and night. Should the gums become 
tender, suspend the mercurial medicines, take a dose of 
salts, and after two or three days proceed as before. If 



139 

tlie pills produce purging, take six to ten drops of 
Laudanum, (No. 16,) with each dose. The mercury 
must be continued at least one week after all is healed. 

The same careful attention to diet mentioned in the 
treatment of gonorrhoea should be observed in this dis- 
ease. 

In the case of chancres that are obstinate, dissolve a 
piece of blue vitrei in a little water, and touch them 
with that once a day, or with a drop of the Mercurial 
solution, (No. 19.) Let the chancres be dressed with 
dry Lint, (No. 35,) or lint dipped in a solution of white 
vitriol several times a day. All obstinate venereal ul- 
cers are to be treated in the same way as chancres. Ill 
case of bubo or hard swellling in the groin, while tak- 
ing the Mercurial Pills or solution, (No. IB,) rub a 
small piece of Mercurial Ointment, (No. 31,) twice or 
three times a day, upon the swelling and the inside of 
the thigh as low down as the knee. Subdue the in- 
flammation early, before matter has formed, by purga- 
tives of salts or seawater, by cold applications to the 
bubo, as salts laid on in a small bag, and frequently 
moistened with cold water. Subsist on a light diet, as 
broths, gruel, sago, barley, rice, puddings, &c. Should 
the swelling not go off in the course of two or three 
weeks, but become hard and painful, it will be neces- 
sary to poultice it, and endeavor to bring it to a head. 
After it becomes perfectly soft, and the matter is felt to 
fluctuate in the tumor, and it is pointed, take the lancet 
and lay it open, so that the matter may be discharged : 
lay a little lint over the orifice, and poultice it until it 
subsides, then dress with Basilicon Salve, (No 30.) 
Should the sore be foul, and not heal kindly, mix lied 
Precipitate, (No. 39,) with the salve, and dress with 
that. 

Venereal warts are sometimes very troublesome. 
When they make their first appearance, touch them 
once or twice a day with Blue Stone, (No. 40,) and mix 
a large proportion of Red Precipitate with Basilicon 
Salve : spread it upon a little lint or rag, and apply it 
directly to the wart; dress once a day. In venereal 
sore throat, the principal dependence is on the exhibi- 



140 

fion of mercury interna] ly. After the mercury has "been 
given some time, and the ulcers do not heal, make a 
strong decoction of White Oak Bark, or if that cannot 
he obtained, of the Bark, (No. 11 7 ) and let the patient 
gargle his throat often with that. Should the ulcers be 
high edged and foul, dissolve a small piece of Blue 
Stone in a little water ; make a swab by winding tow 
around the end of a stick, dip it into this solution, and 
touch the ulcers once or twice a day. The principal 
dependence in the cure of venereal nodes or enlarged 
bones, is likewise to be placed on the internal use of 
Mercurial Pills or solution. It should be continued un- 
til the mouth becomes sore, and the tenderness of the 
gums should be kept up for two or three weeks. Where 
there is much pain and restlessness during the night, 
give 40 drops of laudanum, (No. 16.) It often hap- 
pens that after a person has had the venereal disease 
several times, there appears a troublesome eruption 
on the foreskin and gl ans penis. For this take a tea- 
spoonful of Sugar of Lead, (No. 42,) and the same 
quantity of Calomel, (No. 3 :) add half a pint of soft 
water, shake it thoroughly every time of using, and 
wash four times a day. This wash used once or twice 
a day assists much in the cure of chancres. Venereal 
ulcers in the nose are to be treated much in the same 
way as venereal sore throat. If they do not yield to the 
use of mercury until the mouth becomes tender, which 
should be kept so for two weeks, inject into the nose 
the solution of Sugar of Lead and Calomel twice a 
day. In all the above cases, after the use of mercury, 
if there is much debility, the bark, (No. 11,) should be 
taken three or four times a day, until appetite and 
strength return. 

Preventives. — The newspapers often contain ad- 
vertisements of preventives of venereal diseases. These 
are an imposition and contrary to good morals. There 
is no preventive but total abstinence known to medical 
men, unless it be a recipe that Solomon gives in Pro* 
verbs, chap, v., verse 15th to the end. 



141 

DROPSY OF THE BAG. 

Symptoms. — A collection of water, which is first per- 
ceived at the bottom of the bag increasing in size as it ad- 
vances upwards, and forming a tumor of the shape of a 
pear. If examined as directed for dropsy of the belly, 
the wavy motion may be felt, and if a candle be placed 
behind it, it becomes partly transparent. 

Distinguish it from a rupture by the tumor not swell- 
ing when the patient coughs, — by the tumor having 
commenced at the bottom of the bag, &c. 

From a diseased testicle, by its softness, — the natural 
color of the skin, — absence of pain, — transparency, 
&c, &c. 

Treatment. — When it is first discovered, attempt to 
disperse it by bathing it frequently with (No. 28). The 
only certain cure is an operation, for which, as there is 
no pressing danger, apply to a surgeon. 

ENLARGED SPERMATIC VEIN. 

Symptoms. — A hard, knotty, and irregular swelling 
of the vein, which sometimes increases to a large size. 
When lying down the swelling diminishes, which dis- 
tinguishes it from a dropsy of the parts. 

Treatment. — Suspend the testicles, or keep the pa- 
tient on his back, — apply a Lotion made by dissolving 
a drachm of Sugar of Lead, (No. 42,) in a pint of wa- 
ter to the parts, — the cold bath. 

MERCURIAL DISEASE. 

This is a complaint whose symptoms nearly resem- 
ble the secondary symptoms of pox, consisting of 
blotches on the skin, — pains at night, — ulcers in the 
mouth, &c, &c. Owing to the liberal use of calomel, 
it is now a very common disease, and is frequently con- 
founded, (even by medical men,) with genuine syphilis. 

Treatment. — Abandon every mercurial preparation, 
— use the decoction of lignum vitas and sarsaparilla, — 
the warm bath, and a mild nourishing diet. If possi- 
ble, remove to a healthy situation in the country. It is 
also necessary to take an occasional purgative, of the 
flowers of sulphur or of rhubarb. 



APPENDIX. 



About four years ago Mrs. Maury, some what noto- 
rious as the author of a book entitled u The Statesmen 
of America," became remarkably excited in behalf of 
immigrant passengers in our packet ships. Her move- 
ments were more particularly directed to their supposed 
want of medical attention on their voyage. In a second 
work entitled u An English Woman in America," she 
has occupied nearly two hundred pages with her sayings 
and doings with regard to "Immigrant Surgeons," show- 
ing that the annoyances shipmasters meet with, respect- 
ing medicines, &c, on the other side of the water are 
owing chiefly to her movements there. She sought to 
bring about the same results in this country. She en- 
listed in her efforts Mayors and Aldermen, Boards of 
Health, British Consuls, in New York, Philadelphia,. 
Charleston, New Orleans, Mr. Buchanan, then Secretary 
of State, and lastly President Polk himself. She suc- 
ceeded in getting a numerously signed memorial before 
Congress, which was referred to the Committee of Com- 
merce, of which the Hon. Joseph Grinnell was chair- 
man. She says, p. 100, " The Emigrant Surgeon's bill 
was frustrated in the United States by one man." Her 
efforts having come to my knowledge, and learning that 
she was likely to succeed, I sat down at a late hour one 
evening and wrote the subjoined letter. Mrs. Maury 
has thought that letter and its author worthy some no- 
tice in her last book, and given some garbled extracts 
and some false statements of it, and says that Mr. Grin- 
nell handed her the letter, supposing that it would be 
as satisfactory to her as it was to him that professed 
surgeons were not necessary on board American ships. 
Careful observation and inquiry for more than three 
years past has fully satisfied me that the opinions express- 
ed in the letter are correct. I have collected a great many 
facts of a most gratifying character to substantiate my 
views. While some shipmasters have preferred to be 
free of responsibility, and therefore employed surgeons, 



143 

I have yet to learn that the percentage of deaths has 
been lessened. Of one thing I am certain, that my own 
pocket has been benefited by the increased use of me- 
dicines. I ought therefore personally to be satisfied. I 
know of one ship which during two years had carried 
in sixteen passages about six thousand persons without 
a surgeon. Out of 4653 steerage passengers taken on 
board at Liverpool, she has landed 4651. Of the 
whole number of persons on board there have been 
but eleven deaths. Not one of these contracted the 
disease of which he died on board the ship. Three 
died of consumption, two of chronic diarrhoea, one of 
a urinary difficulty, and three were infants born on 
board. Similar statistics I have no doubt might be fur- 
nished had I time to make inquiry. 

New York, March 24, 1846. 

Sir : — As I was doing some business with Capt. - — — 
at his lodgings last evening, he remarked to another 
shipmaster that he was writing a letter to you respect- 
ing a proposed law requiring emigrant passenger ships 
to carry surgeons. 

I noticed some time since that a memorial upon this 
subject had been made to Congress. I then went to 
Mr. David Hale of the Journal of Commerce and gave 
him many facts, some of 'which you will find below. 
Believing that I occupy a position which enables me 
better to judge of the expediency of the proposed law 
than most men, I have, unsolicited by any one, taken 
the liberty of addressing yon upon the subject. As my 
time is much occupied by my business I am not able to 
give this matter that arrangement which I desire. I 
shall therefore write right on as the ideas present them- 
selves, regardless of order. Your colleague, Julius 
Rockwell, Esq., of Pittsfieid, who was my college-class- 
mate, can inform you whether my character will justify 
a reliance upon my statements. 

Having had a regular medical education, I practiced 
my profession for several years. Under the urgent so- 
licitations of a friend, ten years ago I entered upon the 
apothecary business. Three years afterwards peculiar 
circumstances led me to give particular attention to 



244 

supplying the shipping with medicines. As my Busi- 
ness increased I was obliged to confine my attention al- 
most wholly to this department. 

Probably seven-eighths of Massachusetts vessels, nine- 
tenths of Maine and two-thirds of all the American ves- 
sels, carrying a medicine chest 7 receive their medical 
stores from my establishment. I am of course exten- 
sively acquainted with packet shipmasters and with 
shipmasters generally, J always know if sickness has 
occurred on board during the voyage, and usual] y re- 
ceive an account of the treatment of the patients. Dis- 
locations, fractures, simple and compound, other inju- 
ries, childbirths,, fevers, &c, come under review. I have 
never heard of but one fatal case of child-bed-sickness, 
and that was a case of extreme difficulty even for an 
experienced accoucheur. 

AfteT putting up one thousand medicine chests T pre- 
pared a new medical manaal, two copies of which I 
send you. Some of the best things in it I owe not to 
medical men, but to the experience and ingenuity of 
shipmasters. I have known cases of fractured limb5 
with laceration of the soft parts, which nine surgeons 
out of ten would have treated by amputation, saved un- 
der the surgical skill of the ship captain. I have known 
in two instances of a fractured thigh reduced and heal- 
ed without any perceptible shortening, a rare occur- 
rence under the treatment of the best surgeons. Ship- 
masters generally treat wounds of all kinds with good 
judgment. T would as soon trust those who are forty 
years old in tropical diseases as half of our northern 
physicians, especially if they were novices in the pro- 
fession. The worst case of venereal disease I ever 
knew cured was treated by an American captain. The 
patient was an English sailor left in St. Domingo by his 
English captain to die. In blood-letting, tooth-drawing, 
and other minor operations, our seafaring friends are 
generally expert. Most of them have medical and sur- 
gical works in addition to the manual in the medicine 
chest. In my opinion they are as able to judge of 
symptoms as mere professional tyros, and such proba^ 
bly would be the surgeons on board of passenger ships. 

The late Dr. Nathan Smith r professor of surgery a* 



145 

Yale College, derived a most important hint from the 
quick thought of a sea captain in an emergency occa- 
sioned by the breaking of his tourniquet as he was 
amputating a limb. He ever acted upon it in after life. 
This I have from his own lips. 

I learn that this movement respecting emigrant ship 
surgeons had its origin in two English passengers in 
the ship Hottinguer of this port, British ships may 
need professional surgeons. There are important dif- 
ferences between the masters and seamen of the two 
nations. I understand that custom or law renders it 
obligatory upon the British ship-owner to have a cer- 
tain portion of his crew indentured apprentices. Con- 
sequently many dull, spiritless boys are placed on board 
of vessels and compelled to remain by the force of 
their indentures. When they arrive at manhood wealthy 
and influential friends procure them ships. Such mas- 
ters need the aid of professional surgeons. American 
seamen are essentially a picked class of minds. They 
are universally volunteers. They go to sea because 
they have an enterprise, energy, and decision of char- 
acter which leads them to choose to go to sea. Many 
of them have these characteristics so strongly deve- 
loped as to break through their attachment to home and 
friends, and run away to rove upon the sea. These 
picked minds, as soon as on board ship commence a 
course of education in a constant series of emergencies, 
requiring them to think quickly and act quickly or all 
is lost. Thus they acquire the habit of prompt thought, 
prompt action, and of turning to good account the slen- 
derest means in extricating themselves from difficulties. 
Probably no class of men so often succeed in employ- 
ments fo which they have not been accustomed as sea- 
men. Is it strange then that they are found so compe- 
tent to administer to the sick passengers and crews ? 

I do sincerely believe that if the proposed law should 
pass there will be more lives lost by young physicians 
tampering and fussing with sick passengers than are 
now under the present arrangements. If childbirth oc- 
cur on board ship, and there is not female aid to be ob- 
tained, the master with his books before him will be as 
likely to do as well as a professional tyro, as experience 
13 



146 

in midwifery is of more importance than in any other 
department of the medical profession. 

Not long since a young unmarried Cape Cod captain 
informed me that the husband of one of his passengers 
called upon him to administer to his wife who v as un- 
expectedly taken in labor. " I took your little book," 
said he, " and read and operated, and read again and 
operated, and so went through first-rate." 

Capt. of ship , has successfully attended 

on seven such cases, and Capt. of the London 

packet , has had much larger experience. Should 

small-pox occur, the master will be as competent to treat 
it as a medical novice. [The most successful practi- 
tioner in this disease I ever knew is one of our New 
York shipmasters.] 

It might be well to require that each emigrant ship 
should be supplied with vaccine matter and certain quan- 
tities of medicines and instruments. This is the only 
change in our laws that I think the case calls for. The 
list of articles you will see in my manual comprises 
about all that an intelligent physician would in gene- 
ral find absolutely necessary. I am told that surgeons 
in the East and West Indies rarely send ashore for 
other medicines when prescribing on board ship. 

These are my genuine sentiments after extensive in- 
tercourse with masters and seamen, and putting up four 
thousand medicine chests, eight hundred of which I put 
up last year. I suppose my pecuniary interests would 
be greatly promoted by the passage of the proposed 
act, as double the usual amount of medicine is used 
wherever a physician is employed on board the pas- 
senger vessels. But a sense of justice and some grati- 
tude has led me to volunteer in this business. If the 
above statements shall have any weight in preventing 
further restrictions upon our commerce, already too 
much fettered, I shall not grudge the time bestowed upon 
this letter. Will you please to lay this communication 
before the committee of which you are the chairman, if 
it is proper for you to do so. 

Yours respectfully, THOS. HITTER, M. B. 



To Hon. Jos. Grinnell. 
Chairman of the Com- , 
mittee on Commerce. > 



INDEX. 



Abortion, or Miscar- 
riage, 84 
Amputation, 120 
Apoplexy, 69 
Asthma, 76 
Bark, decoction of, 28 
" infusion u 28 
Bleeding from the nose, 74 
" « lungs, 74 
« " womb, 87 
Blood, spitting of, 74 
" vomiting of, 74 
Blood letting, direc- 
tions for, 120 
Bougies, to introduce, 124 
Brain, compression of, 103 
" concussion of, 103 
Burns and Scalds, 119 
Catheters, to introduce, 124 
Chalk mixture, 32 
Chilblains, 117 
Children, diseases of, 91 
Cholera Asiatic, 65 
Cholera Infantum, 98 
" morbus, 64 
Cholic, 68 
Chordee, 134 
Clap, 132 
Compound accidents, 115 
Convulsions, or Fits, 94 
Corns and Bunions, 126 
Costiveness, 93 
Cough drops, 30 
Coughs and colds, 76 
Croup, 99 



Page. 
Diseases of Children, 91 
Delirium tremens, 71 

Diarrhoea, 61 

" of Children, 96 
Dislocations, 113 

Doses, directions for, 8 
Dropsy of the bag, 141 
Drowned persons, 

treatment of, 123 

Dysentery, 62 

Epileptic Fits, 70 

Erysipelas, 52 

Eyes, to remove dirt, 

&c, from, 118 

Eye Water, 30 

Female Diseases, 84 

Fever, 38 

" Intermittent, 39 

" Bilious remittent, 40 

" Yellow, 41 

" Typhus, 45 

" Inflammatory, 44 

" Scarlet, 48 

Felons, 119 

Fistula, 125 

Fits, 70 

Fractures, 108 

Frosted Limbs, 117 

Gleet, 136 

Gonorrhoea or Clap, 132 

Gravel, ' .77 

Inflammation of the 

bowels, 59 

Inflammation of the 
brain, 55 



148 



Inflammation of the 

liver, 57 

Injection Anodyne, 31 

" Purgative, 31 
" of Tobacco, 116 
Itch, 80 

Jaundice, 58 

Leeches, application of, 125 
Leucorrhcea or Whites, 88 
Lockjaw, 116 

Materia Medica, 9 

Measles, 51 

Measures, 8 

Meconium, retention of, 92 
Medical Practice, 37 

Menses, suppression of, 85 
" excessive, 86 

Mercurial Disease, 141 
Midwifery, 81 

Mortification, 116 

Mustard Poultice, 28 

Nettle-rash, 54 

Neuralgic irritation of 

the Spine, 72 

Piles, 79 

Pleurisy, 56 

Poisons, swallowing of, 127 
Pulse, concerning the, 37 
Quinsy sore throat, 56 

Recipes, 28 

Rheumatism, 60 

Rules, general to pre- 
vent diseases, 34 



Rules, for treatment of 

diseases, 35 

Rupture, 115 

Scales and Weights, 8 

Scurvy, 79 

Secondary List, 23 

Seidlitz Powders, 31 

Small-Pox, 49 

Sore Eyes, 118 

Sprains, 102 

Sprue, 93 

Stricture, 136 

Summer Complaint, 98 

Sun-stroke, 70 

Surgery, 102 

Syphilis or Pox, 138 

Teething, difficult, 94 

Testicles, swelled, 135 

Tobacco Clyster, 116 

Tonic Solution, 30 

Urine, bloody, 75 

" difficulty of, 77 

" suppression of, 78 

Venereal Disease, 138 

Vermin, 80 

Vomiting, 61 

" of Children, 95 

" of blood, 74 

Womb, falling of, 89 

Worms, 95 

Wounds, 103 



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